检测游离PSA和总PSA鉴别前列腺癌和前列腺增生的临床应用

Measurement of free PSA and total PSA to differentiate prostate cancer from BPH

关键词:  游离前列腺特异性抗原  总前列腺特异性抗原  前列腺癌

Key words:  F-PSA  T-PSA  prostate cancer

摘要:

探讨游离前列腺特异性抗原（F-PSA）、总前列腺特异性抗原（T-PSA）及F-PSA和T-PSA比值（F/T），对良性前列腺增生（BPH）和前列腺癌（PCa）患者的鉴别价值。［方法］采用微粒子酶免疫化学发光技术，测定32例健康体检者、120例BPH患者和32例PCa患者的血清F-PSA、T-PSA，并计算其比值F/T。［结果］正常对照组、BPH组与PCa组F-PSA依次为(0.4±0.3)、(2.3±2.4)和(5.9±5.7)μg/L，T-PSA依次为(1.5±1.5)、(11.7±8.8)和(33.9±29.5)μg/L，各组间差异显著（P<0.01）、F/T值BPH组高于PCa组，但标准差过大未有显著性差异（P>0.05）。在T-PSA诊断灰区(4.0～25.0μg/L)中BPH组F/T值高于PCa组（P<0.05）,并且以T-PSA>4.0μg/L、F/T比值<15.0%为界值时效果较好。［结论］ 联合应用T-PSA 、F-PSA及F/T诊断PCa明显优于单用T-PSA。

Abstract:

The authors evaluated the use of free prostate specific antigen(F-PSA), total prostate specific antigen (T-PSA) as well as the ratio of F-PSA to T-PSA (F/T) to improve the discrimination between patients with benign prostatic hyperplasia (BPH) and those with prostate cancer (PCa), especially in patients whose T-PSA values among 4～25μg/L. ［Methods］ Three groups: healthy males 32, males with BPH 120 and males with PCa 32 were included. F-PSA and T-PSA were measured with microparticle enzyme chemiluminescent immunoassay (MECIA) and the F/T ratio was calculated. ［Results］ T-PSA and F-PSA of groups with PCa and BPH and of the healthy persons were (33.9±29.5) μg/L、(5.9±5.7) μg/L，(11.7±8.8) μg/L、(2.3±2.4) μg/L and (1.5±1.5) μg/L 、(0.4±0.3) μg/L respectively with significantly differences. The F/T ratio of group BPH was higher than those of PCa, but without significant difference. However the F/T ratio of group BPH was significantly higher than that of PCa in the zone in which the T-PSA changed in (4.0～25.0)μg/L(the diagnostic gray zone). ［Conclusion］ Detection of both F-PSA and T-PSA is helpful to differentiate the patients with PCa from those with BPH.