cPSAD在汉族人群PSA灰区前列腺癌早期筛查中的应用研究  

The Utility of Complexed Prostate Specific Antigen Density(cPSAD) for Early Detection Proatate Cancer in Han Population with Different Serum PSA Levels

作　　者：王于勇[1] 于志坚[1] 俞蔚文[1] 廖国栋[1] 王刚[1] 王兵[1] 何翔[1] 何华东[1] 潘毓鸣[1] 郑祥毅[2] 

机构地区：[1]杭州市第一人民医院泌尿外科,310006 [2]浙江大学医学院附属第一医院泌尿外科

出　　处：《医学研究杂志》2011年第11期75-78,共4页Journal of Medical Research

基　　金：2009年浙江省医药卫生科技计划项目(2009A161)

摘　　要：目的研究cPSAD在汉族人群PSA灰区前列腺癌早期筛查中的应用价值。方法 2002年1月～2010年12月收集了265例PSA水平介于4～10ng/ml并接受前列腺穿刺活检的患者,通过接收者工作特征曲线(ROC)分析法评价PSA值、f/tP-SA值、PSAD值和cPSAD值在预测诊断前列腺癌中的敏感性和特异性,寻找敏感性和特异性较好的前列腺癌早期预测指标。结果 265例患者中,63例为前列癌患者,占23.77%。PSA、cPSA、PSAD、t/fPSA、cPSAD 5个参数的ROC曲线下面积分别为:0.603、0.706、0.865、0.800、0.875,在所有参数中,cPSAD的AUC最大,较其他参数有更高的诊断效率。cPSAD取截点为0.0970ng/ml2时可达到90%的敏感度和63.4%的特异度,取截点为0.1296ng/ml2时可达到85%的敏感度和78.7%的特异度。结论在汉族人群PSA灰区前列腺癌早期筛查诊断中,cPSAD较其他目前常用的PSA相关指标更具优势。Objective To investigate the utility of cPSAD for early detection proatate cancer in Han population with serum PSA lev- els of 4 - lOng/ml. Methods Form January 2002 to December 2010,265 men with total PSA levels of 4 - lOng/ml participated in a protocol for prostate - cancer screening, and eligible patients were recommended for prostate biospies. The diagnostic value of PSA, cPSA, PS- AD,the free -to -total PSA ratio （f/tPSA） and cPSAD were compared using receiver operating characteristic （ROC） analysis. Results Prostate cancer was diagnosed in 63 （23.77%） of the 265 men. The area under the curve（AUC） of PSA, cPSA, PSAD,t/fPSA and cPSAD were 0. 603,0. 706,0. 865,0. 800 and 0. 875 respectively. The AUC of cPSAD was the largest in all of the PSArelated indicators,and cPSAD was the best indicator of prostate cancer. The sensitivity and specificity of cPSAD at a cutoff of 0. 0970ng/ml2 was 90.0% , 63.4% respectively,and the sensitivity and specificity of ePSAD at a cutoff of 0. 1296ng/ml2 was 85% , 78.7% respectively. Conclusion cPSAD was better than the other PSA derivatives for early dectection prostate cancer in Han population with serum PSA levels of 4 -10ng/ml.

关 键 词：cPSAD 前列腺癌 PSA PSA灰区 

分 类 号：R737.25[医药卫生—肿瘤]