PSA、PSAD、F-PSA/PSA在前列腺癌诊断中的价值  

A appraise of PSA, PSAD and F-PSA/PSA in diagnosis of prostatic cancer

作　　者：邓家德[1] 万建新[2] 陈蕃[1] 

机构地区：[1]广州市第一人民医院检验科,广东广州510180 [2]中山医科大学附属一院检验科

出　　处：《中国实验诊断学》2001年第6期293-294,共2页Chinese Journal of Laboratory Diagnosis

摘　　要：目的 评价ＰＳＡ、ＰＳＡＤ、Ｆ－ＰＳＡ／ＰＳＡ在Ｐｃａ诊断中的价值。方法 采用放射免疫分析方法测定２０例Ｐｃａ和６０例ＢＰＨ患者血清中的ＰＳＡ、ＰＳＡＤ、Ｆ－ＰＳＡ，用ＲＯＣ曲线评价它们在厌诊断中的价值。结果Ｐｃａ患者血清中ＩＳＡ、ＰＳＡＤ明显高于 ＢＰＨ，Ｆ－ＰＳＡ／ＰＳＡ明显低于 ＢＰＨ，存在统计学意义的差异（Ｐ＜０．０１）；以 ＰＳＡ＞４．０μｍｏｌ／Ｌ、ＰＳＡＤ＞０．２、Ｆ－ＰＳＡ ／ＰＳＡ＜０．１５，为临界值，ＰＳＡ的敏感性高于 ＰＳＡＤ、Ｆ－ＰＳＡ／ＰＳＡ，而特异性、诊断指数、诊断效率、阳性预测值、Ａｕｃ明显低于后者，ＰＳＡＤ、Ｆ－ＰＳＡ／ＰＳＡ两者诊断效果相似。结论 提示ＰＳＡ仍然是诊断和监测Ｐｃａ的最重要指标，但在ＰＳＡ＞４．０μｍｏｌ／Ｌ时，选择性的测量ＰＳＡＤ或Ｆ－ＰＳＡ／ＰＳＡ，能提高Ｐｃａ诊断的特异性，减少不必要的组织学穿刺活检。Objective Evaluate PSA, PSAD and F-PSA/PSA In diagnosis efficiency of prostatic cancer. Methods PSA, PSAD and F-PSA/PSA levels in serum 60 patients with BPH and 20 patients with Pca were assayed by radioimmunoassay. Results It was found that PSA and PSAD levels in serum patients with Pca was higher than BPH, F-PSA/PSA was lower, they have statistics difference between Pca and BPH(P < 0. 01) , When the upper normal limits of PSA and PSAD were set at 4. 0 μmol/L and 0.20,and the lower normal limit of F-PSA/PSA was set at 0. 15, the sensitivity PSA,PSAD and F-PSA/PSA were 90% , 80% ,85% , the diagnostic efficiency 55% , 85% , 83% , the specificity 43% , 87% , 82% , the diagnostic index 133% , 167% , 167 % , the positive predict value 35 % , 67 % , 61 % , Auc 0. 66,0. 83,0. 83. both importance of PSAD and F-PSA/PSA are resem-ble. Conclusion It suggests that PSA is still the most important target in diagnosis of prostatic cancer, but when PSA is over 4.0 μmol/L, the use of PSAD or F-PSA/PSA aid to improve the specificity and the positive predict value of prostatic cancer diagnosis and due to the reduced rate of negative biopsies.

关 键 词：ROC曲线 前列腺癌 前列腺特异性抗原 前列腺特异性抗原密度 PSA PSAD F-PSA/PSA 游离前列腺特异性抗原比率 

分 类 号：R737.25[医药卫生—肿瘤]