基于分位数回归建立tPSA、fPSA、fPSA/tPSA的年龄特异性参考区间  

Age-specific reference ranges of tPSA,fPSA and fPSA/tPSA established based on quantile regression

作　　者：刘凤玲[1] 张桐硕 祝峰[1] 汤元杰[2] LIU Fengling;ZHANG Tongshuo;ZHU Feng;TANG Yuanjie(Department of Clinical Laboratory,Jiangsu Provincial Corps Hospital,Chinese Peple′s Armed Police Forces,Yangzhou 225003,Jiangsu,China)

机构地区：[1]武警江苏省总队医院检验科,江苏扬州225003 [2]武警江苏省总队医院泌尿外科,江苏扬州225003

出　　处：《临床检验杂志》2021年第1期65-68,共4页Chinese Journal of Clinical Laboratory Science

基　　金：扬州市医学领军人才(创新团队)培养项目。

摘　　要：目的观察江苏扬州地区健康男性总前列腺抗原(tPSA)、游离前列腺抗原(fPSA)以及二者比值(fPSA/tPSA)随年龄的变化趋势,建立实验室的特异性参考区间。方法收集2018年武警江苏总队医院健康体检男性3402例,最终纳入分位数回归分析1369例,收集tPSA、fPSA、fPSA/tPSA检测结果;利用R语言程序包分别拟合tPSA、fPSA、fPSA/tPSA的5%和95%分位点的回归模型,探索年龄因素对参考区间分布的影响,以10年为1个亚组建立不同年龄段的参考区间。结果tPSA、fPSA、fPSA/tPSA结果呈明显的偏态分布,并存在年龄依赖性。tPSA和fPSA的参考区间上限值(95%分位点)在30~40岁最低,随后升高,呈“U”型分布;fPSA/tPSA的参考区间下限值(5%分位点)整体呈降低趋势。结论分位数回归模型对于建立PSA等非正态分布检验指标的参考区间有良好的适用性,可通过分位数回归模型修正或完善试剂说明书所给的参考区间,按年龄等影响因素建立所在实验室的特异性参考区间。Objective To observe the age-related change trend of total prostate antigen( t PSA),free prostate antigen( f PSA) and their ratio( f PSA/t PSA) of healthy men in Yangzhou,Jiangsu province,and establish a specific reference range for our laboratory.Methods A total of 3 402 health male examinees were selected in Jiangsu Armed Police Corps Hospital in 2018,and 1 369 samples were finally involved in the quantile regression analysis. The results of t PSA,f PSA and f PSA/t PSA were extracted from electronic medical record mining system. The 5% and 95% quantile regression models of t PSA,f PSA and f PSA/t PSA were fitted by R language package,and the influence of age on the distribution of reference interval was explored. The reference intervals for different age groups were established with 10 years as a subgroup. Results The results of t PSA,f PSA,f PSA/t PSA showed significant skewness distribution and age dependence. The upper limit( 95% quantile) of the reference range of t PSA and f PSA during 30 to 40 years old was the lowest,and then increased,showing the distribution a shape of " U",while the lower limit( 5% quantile) of the reference range of f PSA/t PSA showed a decreasing trend overall. Conclusion The quantile regression model should be suitable for establishing the reference range of PSA and other non-normal distribution test paremeters. The reference range given by reagent specification could be revised or improved by quantile regression model,and the specific reference range of laboratory may be established by age and other influence factors.

关 键 词：前列腺特异抗原 参考区间 分位数回归 年龄 

分 类 号：R446[医药卫生—诊断学]