性激素在前列腺癌早期诊断中的作用及与PSA的关系  

The role of sex hormone in early diagnosis of prostate cancer and its correlation with prostate specific antigen

作　　者：徐辉[1] 王志勇[1] 常辉[1] 王振潮[1] 马光[1] 马英慧[2] Xu Hui Wang Zhiyong Chang Hui Wang Zhenchao Ma Guang Ma Yinghui(Department of Urology, Affiliated Hospital of Chengde Medical College, Chengde 067000 China Department of Ophthalmology, Affiliated Hospital of Chengde Medical College)

机构地区：[1]承德医学院附属医院泌尿外科,承德067000 [2]承德医学院附属医院眼科

出　　处：《中国男科学杂志》2017年第4期51-54,共4页Chinese Journal of Andrology

基　　金：承德市科学技术研究与发展计划项目(项目编号:20142072)

摘　　要：目的探讨血清性激素在前列腺癌(PCa)诊断中的作用价值及与前列腺特异性抗原(PSA)的关系。方法 PCa患者30例、良性前列腺增生症(BPH)患者45例及正常人45例,检测睾酮(T)、雌二醇(E2)、孕酮(P)、卵泡刺激素(FSH)、黄体生成素(LH)及泌乳素(PRL)和PSA的水平。比较各组间性激素及PSA的差异。分析性激素及PSA对PCa的诊断价值及两者的相关性。结果 PCa组中T降低明显,FSH、LH增高明显;总PSA(tPSA)、游离PSA(fPSA)、PSA密度(PSAD)增高明显,fPSA与tPSA比值(f/tPSA)降低明显。tPSA、fPSA、PSAD、T、FSH、LH的ROC曲线下面积(AROC)分别为1.000、0.894、0.991、0.920、0.753、0.868;各检测参数AROC比较,tPSA和PSAD、fPSA和T、fPSA和LH、PSAD和T、T和LH、FSH和LH配对比较差异无统计学意义(P>0.05),余配对比较差异有统计学意义(P<0.05)。相关性分析结果显示,PCa患者tPSA与T有相关性(P<0.05),与E2、P、FSH、LH及PRL水平无相关性(P>0.05)。结论 PCa患者T水平降低,FSH、LH水平增高。PCa患者PSA与血清T有相关性,T、FSH和LH对早期PCa具有与tPSA、f/tPSA和PSAD接近相同的诊断能力。血清PSA联合性激素T、FSH和LH检测有助于PCa的早期诊断。Objecive Abstract Objecive To explore diagnostic value of serum sex hormone in prostate cancer（PCa）and its correlation with prostate specific antigen（PSA）. Methods Methods Thirty patients with PCa, 45 patients with benign prostatic hyperplasia（BPH） and 45 normal subjects were enrolled in the study. The levels of serum T, FSH, LH, E2, P, PRL and PSA were examined in these group. Differences of sex hormone and PSA were compared among groups. The diagnostic value of sex hormone and PSA for PCa and their correlation were analyzed. Results Results The T level in patients with PCa was significantly decreased but FSH and LH were significantly increased. The serum total PSA（tPSA）, free PSA（fPSA） and PSA density（PSAD） levels in patients with PCa were significantly increased but ration of free PSA to total PSA（f/tPSA） was significantly decreased. The areas under the receiver operating characteristic curves（AROC） of tPSA, fPSA, PSAD, T, FSH and LH were 1.000, 0.894, 0.991, 0.920, 0.753, 0.868 respectively. There was no statistical significance in AROC between tPSA and PSAD, fPSA and T, fPSA and LH, PSAD and T, T and LH, FSH and LH（P 0.05）, and there was statistical significance between the remaining pair（P 0.05）. Correlation analysis showed that serum tPSA level was correlated with serum T level in PCa patients（P 0.05）, but no correlation with serum E2, P, FSH, LH and PRL levels（P 0.05）. Conclusion Conclusion The level of serum T decreased, whereas FSH and LH levels increased in patients with PCa. The PSA level was correlated with the serum T level in PCa patients. T, FSH and LH had almost the same diagnostic ability with TPSA, f/tPSA and PSAD for early PCa. The combined detection of the serum PSA and the sex hormone T, FSH, LH was a valuable tool for early diagnosis of PCa.

关 键 词：性腺甾类激素 前列腺肿瘤 前列腺特异抗原 

分 类 号：R737.25[医药卫生—肿瘤]