游离前列腺特异性抗原与总前列腺特异性抗原比值在不同总前列腺特异性抗原水平时对提高前列腺癌检出率的价值  

THE DIAGNOSIS VALUE OF F/TPSA RATIO FOR PROSTATE CANCER WITH DIFFERENT SERUM TPSA LEVELS

作　　者：李林[1] 阎成全[1] 翟玉普 王贺峰[3] 孟斌[1] 时京[4] Li Lin;Yan Chengquan;Zhai Yupu;et al(Department of Urology , Tangshan Gongren Hospital of Hebei Medical University, Tangshan 063007 ,Chin)

机构地区：[1]河北医科大学附属唐山市工人医院泌尿外科,河北省唐山市063007 [2]唐山市丰南区中医医院泌尿外科 [3]开滦总医院林西医院肿瘤外科 [4]中国人民解放军总医院泌尿外科

出　　处：《中国煤炭工业医学杂志》2017年第12期1425-1429,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省医学科学研究重点课题计划项目(编号:20160846)

摘　　要：目的探讨游离前列腺特异性抗原(fPSA)与总前列腺特异性抗原比值(f/tPSA)在tPSA4~10、10~20及>20 ng/ml水平时对筛查前列腺疾病确定是否需要穿刺或重复穿刺,提高前列腺癌(PCa)检出率的价值。方法回顾性分析2013年1月—2015年12月就诊于我院行前列腺穿刺活检术及PCa相关手术,术前血清tPSA≥4 ng/ml且依据前列腺病理学检查报告明确诊断为PCa和非PCa共计402例患者的临床资料,比较二组患者tPSA水平与f/tPSA比值的差异,绘制受试者工作特征曲线(ROC),分析f/tPSA比值在不同tPSA水平对PCa的诊断价值。结果在所纳入的402例患者中,PCa患者146例,非PCa患者256例。在tPSA处于4~10 ng/ml和11~20 ng/ml时,二组的tPSA水平比较差异无统计学意义(P>0.05),二组的f/tPSA比值比较差异有统计学意义(P<0.01)。在tPSA>20 ng/ml时,二组的tPSA水平比较差异有统计学意义(P<0.01),而二组的f/tPSA比值比较差异无统计学意义(P>0.05)。t/fPSA比值在tPSA4~10 ng/ml和10~20 ng/ml区段ROC曲线下面积(AUC)分别为0.739和0.743。结论在tPSA处于4~10 ng/ml和11~20 ng/ml时,t/fPSA比值能有效筛查前列腺疾病是否需要穿刺或重复穿刺,提高PCa的检出率。Objective To investigate the diagnostic value of f/tPSA ratio for prostate cancer with serum tPSA levels of 4~10 ng/ml,10~20 ng/ml and20 ng/ml.Methods A retrospective study was performed among402 cases of PCa or non-PCa whose tPSA greater than or equal to 4 ng/ml,and whose diagnosis were confirmed by pathology through prostate biopsy and prostate surgery in our hospital from January 2013 to December 2015.TPSA and f/tPSA ratio were obtained and receiver operating characteristic（ROC）curve was used to evaluate the efficiency of f/tPSA ratio in the diagnosis of prostate cancer.Results When tPSA was in4~10 ng/ml and 10~20 ng/ml,the difference of tPSA between prostate cancer group and non-prostate cancer group was not obvious,and f/tPSA ratio in prostate cancer group was significantly lower than that in nonprostate cancer group.When tPSA was in20 ng/ml,the difference of tPSA was statistically significant,but there was no differences in f/tPSA ratio.The area under ROC curve of f/tPSA ratio in diagnosing PCa with 4~10 ng/ml and 10~20 ng/ml were 0.739 and 0.743,respectively.Conclusion f/tPSA ratio has better diagnosis efficiency in prostate cancer with tPSA levels of 4~10 ng/ml and 10~20 ng/ml.

关 键 词：前列腺癌 前列腺特异性抗原 游离前列腺特异性抗原/总前列腺特异性抗原 

分 类 号：R730.4[医药卫生—肿瘤]