良性前列腺增生患者临床参数间的相关性分析及方法学评价  

A Correlation Analysis and Methodological Evaluation of Clinical Parameters in Patients with Benign Prostatic Hyperplasia

作　　者：金晶[1] 潘玥[1] 陀佳瑶 聂秀娟 JIN Jing;PAN Yue;TUO Jiayao;NIE Xiujuan(Beijing Haidian Hospital,Beijing 100090,China)

机构地区：[1]北京市海淀医院,北京100090

出　　处：《标记免疫分析与临床》2024年第1期52-57,共6页Labeled Immunoassays and Clinical Medicine

基　　金：科技部国家重点研发计划老年前列腺增生的综合防控技术研究与精准风险评估和个体化防治措施(编号:2021YFC2009300)。

摘　　要：目的探讨良性前列腺增生患者的前列腺体积、患者年龄、血清总前列腺特异性抗原(TPSA)、血清游离前列腺特异性抗原(FPSA)、前列腺特异性抗原密度(PSAD)的相互关系,同时通过患者年龄预测前列腺体积(PV)大小的准确性。研究胶乳免疫比浊法检测血清TPSA、FPSA水平与电化学发光法比较的可行性和实用性。方法收集172例患者的临床资料进行统计学分析,总结患者年龄、前列腺体积、TPSA、FPSA及PSAD的相关性,并使用受试者特征ROC曲线分析血清TPSA、FPSA预测前列腺体积的准确性。用两种方法同时检测血清TPSA和FPSA,比较其相关性、偏差和阴阳性符合率。结果患者TPSA,FPSA,PV随年龄增高而增大(r=0.318、0.325、0.511,P均<0.01),TPSA和FPSA也随PV增大而增高(r=0.279、0.368,P均<0.01)。与TPSA相比,FPSA与患者年龄、PV的相关性更强。TPSA水平<4ng/mL时,对于前列腺体积30~49mL、50~79mL和>80mL 3组,TPSA预测的AUC为0.621、0.708、0.913,最佳临界值分0.7、1.98、2.37ng/mL;FPSA预测的AUC为0.682、0.711、0.832,最佳临界值为0.37、0.56、0.81ng/mL。电化学发光法与胶乳免疫比浊法检测TPSA、FPSA相关性良好(r=0.986、0.975,P均<0.01);两种方法检测TPSA结果和FPSA结果的一致性良好;二者的阳性符合率、阴性符合率和总符合率分别为98.63%和90.54%、93.94%和96.94%、96.51%和94.18%,Kappa值为0.930、0.850(P均<0.01)。其精密度,线性范围和参考区间验证均符合标准。结论患者年龄、前列腺体积、TPSA水平、FPSA水平之间有显著的相关关系。血清TPSA和FPSA作为临床上独立预测PV的简便可行的因子具有较高准确性,其中FPSA预测的准确性更高。胶乳免疫比浊法与电化学发光法比较一致性较好,胶乳免疫比浊法可以作为检测TPSA和FPSA水平的推荐方法。Objective To evaluate the correlation between prostate volume,age,serum total prostate specific antigen(TPSA),serum free prostate specific antigen(FPSA),and prostate-specific antigen density(PSAD)in patients with benign prostatic hyperplasia(BPH),and to study the accuracy of predicting prostate volume PV size by patient age.To further study the feasibility and practicability of detecting serum TPSA and FPSA by latex immunoturbidimetry compared with electrochemical luminescence method.Methods Clinical data of 172 patients were collected for the statistical analysis,and the correlation between age,prostate volume,TPSA,FPSA and PSAD was summarized.The accuracy of serum TPSA and FPSA in predicting prostate volume was evaluated by receiver characteristic ROC curve.Serum TPSA and FPSA were detected by two methods at the same time,and their correlation,deviation analysis and positive and negative coincidence rate were compared.Results TPSA,FPSA and PV increased with increasing age(r=0.318,0.325,0.511,all P<0.01).TPSA and FPSA also increased with increasing PV(r=0.279,0.368,all P<0.01).Compared with TPSA,FPSA was more strongly correlated with patient age and PV.When TPSA level was<4ng/mL,AUCs predicted by TPSA were 0.621,0.708 and 0.913 for prostate volume of 30-49mL,50-79mL and>80mL,and the optimal critical values were 0.7ng/mL,1.98ng/mL and 2.37ng/mL,respectively.AUCs predicted by FPSA were 0.682,0.711 and 0.832,and the optimal critical values were 0.37ng/mL,0.56ng/mL and 0.81ng/mL,respectively.TPSA and FPSA were well correlated with latex immunoturbidimetry(r=0.986,0.975,P<0.01).The results of TPSA and FPSA measured by the two methods were in a good agreement.The positive coincidence rate,negative coincidence rate and total coincidence rate were 98.63%and 90.54%,93.94%and 96.94%,96.51%and 94.18%,respectively,and Kappa values were 0.930 and 0.850(P<0.01).Its precision,linear range and reference interval verification all met the standards.Conclusion There is a significant correlation between patient age,prostate volume,

关 键 词：良性前列腺增生 前列腺特异性抗原 游离前列腺特异性抗原 年龄 前列腺体积 胶乳免疫比浊法 电化学发光法 

分 类 号：R697.32[医药卫生—泌尿科学]