p2PSA、p2PSA%、PHI在前列腺癌辅助诊断中的价值  

Role of p2PSA,p2PSA%and PHI in the diagnosis of prostate cancer

作　　者：权衡 朱婧 廖焕金 伍均 QUAN Heng;ZHU Jing;LIAO Huanjin;WU Jun(Department of Clinical Laboratory,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 200080,China;Department of Clinical Laboratory,Jiading Branch,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 201803,China)

机构地区：[1]上海交通大学附属第一人民医院检验科,上海200080 [2]上海交通大学附属第一人民医院嘉定分院检验科,上海201803

出　　处：《检验医学》2021年第7期705-709,共5页Laboratory Medicine

基　　金：国家自然科学基金面上项目(82072892);上海市自然科学基金面上项目(21ZR1454900);上海市嘉定区重点学科项目(2020-jdyxzdxk-13)。

摘　　要：目的探讨前列腺特异性抗原同源异构体2(p2PSA)、前列腺特异性抗原同源异构体2百分比(p2PSA%)和前列腺健康指数(PHI)在鉴别良性、恶性前列腺疾病中的价值。方法选取行经直肠超声引导前列腺穿刺活检的男性患者250例,根据病理结果分为良性前列腺疾病组(145例)和前列腺癌组(105例),将所有患者按年龄分为≤65岁和>65岁2个年龄段。检测所有患者血清总前列腺特异性抗原(t-PSA)、游离前列腺特异性抗原(f-PSA)和p2PSA,并计算游离前列腺特异性抗原百分比(f-PSA%)、p2PSA%和PHI。采用受试者工作特征(ROC)曲线评估各项指标诊断前列腺癌的效能。结果与良性前列腺疾病组比较,前列腺癌组t-PSA、p2PSA、p2PSA%、PHI均显著升高(P<0.01、P<0.001),f-PSA%显著降低(P<0.001),f-PSA差异无统计学意义(P>0.05)。ROC曲线分析结果显示,在≤65岁的患者中,t-PSA、f-PSA、f-PSA%、p2PSA、p2PSA%、PHI诊断前列腺癌的曲线下面积(AUC)分别为0.687、0.500、0.792、0.815、0.795、0.892;在>65岁的患者中,t-PSA、f-PSA、f-PSA%、p2PSA、p2PSA%、PHI诊断前列腺癌的AUC分别为0.748、0.542、0.900、0.780、0.843、0.929。结论前列腺癌标志物在不同年龄段中的诊断效能有一定差异。新型前列腺癌标志物PHI、p2PSA、p2PSA%可提高良性、恶性前列腺疾病的鉴别诊断效能。Objective To investigate the diagnostic value of prostate-specific antigen isoform 2(p2PSA),prostate-specific antigen isoform 2 percentage(p2PSA%)and prostate health index(PHI)in the identification of benign and malignant prostate diseases.Methods A total of 250 male patients who underwent transrectal ultrasound-guided prostate biopsy were enrolled and classified into benign prostate disease group(145 cases)and prostate cancer group(105 cases)based on the pathological results,and they were classified into≤65 years old and>65 years old groups according to ages.Total prostate-specific antigen(t-PSA),free prostate-specific antigen(f-PSA)and p2PSA were determined in serum samples from all the patients,and free prostate-specific antigen percentage(f-PSA%),p2PSA%and PHI were calculated.The efficiency of each index in the diagnosis of prostate cancer was evaluated by receiver operating characteristic(ROC)curve.Results Compared with benign prostate disease group,the t-PSA,p2PSA,p2PSA%and PHI of prostate cancer group were increased(P<0.01,P<0.001),and f-PSA%was decreased(P<0.001).There was no statistical significance in f-PSA between the 2 groups(P>0.05).ROC curve analysis results showed that,in≤65 years old patients,the areas under curves(AUC)of t-PSA,f-PSA,f-PSA%,p2PSA,p2PSA%and PHI in the diagnosis of prostate cancer were 0.687,0.500,0.792,0.815,0.795 and 0.892,respectively.In>65 years old patients,the AUC of t-PSA,f-PSA,f-PSA%,p2PSA,p2PSA%and PHI in the diagnosis of prostate cancer were 0.748,0.542,0.900,0.780,0.843 and 0.929,respectively.Conclusions The diagnostic efficiency of prostate cancer markers differs in different ages.Prostate cancer markers,PHI,p2PSA and p2PSA%,can improve the differential diagnosis of benign and malignant prostate diseases.

关 键 词：前列腺特异性抗原同源异构体2 前列腺特异性抗原 前列腺癌 

分 类 号：R446.1[医药卫生—诊断学]