TPSA、FPSA及其比值在前列腺癌诊断中的意义  

TPSA, FPSA , and ratio of FPSA/TPSA for diagnosing prostate carcinoma

作　　者：邹碧姬[1] 符月春[1] 陈文思[1] 

机构地区：[1]中山大学附属第三医院检验科,广州510630

出　　处：《国际医药卫生导报》2013年第23期3619-3622,共4页International Medicine and Health Guidance News

摘　　要：目的 探讨游离前列腺特异性抗原（FPSA）、总前列腺特异抗原（TPSA）及FPSA与TPSA的比值（FPSA/TPSA）对前列腺癌（PCa）的诊断意义.方法 收集经前列腺穿刺活检病理诊断确诊的前列腺癌患者115例和前列腺增生（BPH）患者143例.采用化学发光微粒子免疫法测定技术（CMIA）检测两组血清TPSA、FPSA水平.分别在TPSA 4.0～10.0 μg/L、10.0～50.0μg/L、＞ 50.0μg/L三个区间范围内,以FPSA/TPSA＜0.18作为诊断临界点,分析PCa、BPH在同一TPSA水平的符合率差异,并计算上述各区间范围内FPSA/TPSA诊断PCa的灵敏度、特异度、阳性预测值、阴性预测值.结果 以FPSA/TPSA＜0.18作为诊断临界点,在TPSA 4.0 ～ 10.0 μg/L区域,两组患者的疾病诊断符合率差异无统计学意义（P＞0.05）,在TPSA 10.0～50.0 μg/L和TPSA＞ 50.0μg/L区域,两组患者疾病诊断符合率差异有统计学意义（P＜0.005）,且在TPSA从低到高区间范围内,FPSA/TPSA诊断PCa的效能越来越高且差异具有统计学意义（P＜0.05）,灵敏度分别为46.67％、67.39％、89.74％;特异度分别为66.00％、84.44％、72.22％;阳性预测值分别为45.16％、81.58％、87.50％;阴性预测值分别为67.35％、71.70％、76.47％.结论 患者血清TPSA含量越高,诊断前列腺癌的准确率越高,TPSA、FPSA和FPSA/TPSA比值可作为诊断PCa的参考指标.Objective To investigate the clinical significance of total prostate-specific antigen （TPSA）, free prostate specific antigen （FPSA）, and the ratio of FPSA/TPSA for diagnosing prostate carcinoma （PCa）. Methods 115 patients with PCa and 143 patients with benign prostate hyperplasia （BPH） diagnosed by the pathological biopsy of prostate were collected. Their serum TPSA and FPSA levels were detected by chemiluminescent microparticle immunoassay （CMIA） technology. Taking FPSA/TPSA 〈 0.18 as the cut off value, the accuracy rate differences of the same level of TPSA between the PCa and BPH patients were analyzed and the sensitivities, specificities, positive predictive values, and negative predictive values of FPSA/TPSA for diagnosing PCa were calculated when the levels of TPSA ranged 4.0-10.0 μ g/L, 10.0-50.0 μ g/L, and 〉 50.0 μg/L, respectively. Results Taking FPSA/TPSA 〈 0.18 as the cut off value, when the level of TPSA ranged from 4.0 to 10.0 μg/L, there was no statistical difference in diagnosis accuracy rate between BPH and PCa patients （P 〉 0.05）; when the level of TPSA ranged form 10.0 to 50.0 μ g/L or 〉 50.0 μg/L, there were statistical differences in diagnosis accuracy rate between BPH and PCa patients （P 〈 0.005）. The higher the level of TPSA was, the more accurately PCa could be diagnosed by FPSA/TPSA and there was statistical difference （P 〈 0.05）. The sensitivities were 46.67%, 67.39%, and 89.74%, the specificities were 66.00%, 84.44%, and 72.22%, the positive predictive values were 45.16%, 81.58%, and 87.50%, and the negative predictive values were 67.35%, 71.70%, and 76.47% when the levels of TPSA ranged 4.0-10.0 μ g/L, 10.0-50.0 μ g/ L, and 〉 50.0 μ g/L, respectively. Conclusions The higher the level of TPSA is, the more accurately PCa could be diagnosed by FPSA/TPSA. It suggests that TPSA, FPSA, and the ratio of FPSA/TPSA can be used as a reference index for diagnosing PCa.

关 键 词：前列腺特异性抗原 前列腺癌 诊断 

分 类 号：R737.25[医药卫生—肿瘤]