前列腺特异抗原与前列腺体积及移行带体积比在前列腺癌筛选中的意义  

The significance of serum prostate specific antigen(PSA) density and PSA density of the transition zone for the early detection of prostate cancer

作　　者：王建业[1] 刘明[1] 万奔[1] 张力青[1] 钟晨阳[1] 陈敏[2] 邓京平[1] 邓庶民[1] 许进[1] 

机构地区：[1]卫生部北京医院泌尿外科,100730 [2]卫生部北京医院放射科,100730

出　　处：《中华老年医学杂志》2002年第2期109-112,共4页Chinese Journal of Geriatrics

摘　　要：目的　探讨血清前列腺特异抗原 (PSA)及其密度 (PSAD)及移行带密度 (PSA TZ)在前列腺癌筛选中的意义。　方法　回顾性分析 15 3例血清PSA <2 0ng/ml的因怀疑前列腺癌而进行前列腺穿刺活检的患者 ,对PSAD及PSA TZ与活检结果进行分析。　结果　活检结果前列腺增生 (BPH)10 0例 ,前列腺癌 (PCa) 5 3例。BPH和PCa组平均PSAD分别为 (0 13± 0 11)和 (0 30± 0 2 1)ng·ml-1·ml-1,PSA TZ分别为 (0 2 6± 0 2 0 )和 (0 78± 0 71)ng·ml-1·ml-1,PCa组明显升高 ,均为P <0 0 1。以前列腺体积 5 0ml或移行带体积 2 5ml为界 ,体积较小BPH和PCa组间的平均PSAD和PSA TZ差异更明显。PSAD及PSA TZ的ROC曲线下面积 (分别为 0 73及 0 74)明显大于PSA(0 5 7) ,但两者间差异无显著性。　结论　当血清PSA <2 0ng/ml时 ,PSAD及PSA TZ在前列腺癌的筛选中要优于PSA 。Objective To define the role of serum PSA density (PSAD) and PSA density of the transition zone (PSA-TZ) for the early detection of prostatic cancer(PCa). Methods The retrospective study included 153 patients being suspected for early PCa with serum PSA<20 ng·ml -1. Biopsy of the prostate was performed for all these patients. Results Of 153 patients, 100 were histologically confirmed as benign prostatic hyperplasia(BPH) and 53 as PCa. There was significant difference in mean PSAD and PSA-TZ between the PSA positive and PSA negative patients. PSAD was (0.13±0.11)ng·ml -1·ml -1 for the negative and (0.30±0.21)ng·ml -1·ml -1 for the positive. PSA-TZ was (0.26±0.20)ng·ml -1·ml -1 for the negative and (0.78±0.71)ng·ml -1·ml -1 for the positive. The difference was more obvious in smaller prostate (the prostate volume <50 ml or the transition zone <25 ml). In ROC curves, area under the curve of PSAD(0.73) and PSA-TZ(0.74) had no difference but both of them were much larger than that of PSA(0.57). Conclusions PSAD and PSA-TZ are more accurate in screening the prostatic cancer than PSA in patients with PSA<20 ng·ml -1 and the cut-off value should be adjusted according to the volume of prostate or its transion zone.

关 键 词：前列腺肿瘤 前列腺特异抗原 诊断 

分 类 号：R737.25[医药卫生—肿瘤] R730.45[医药卫生—临床医学]