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游离PSA与总PSA比值在前列腺疾病诊断中的应用(1)
http://www.100md.com 2011年4月1日 罗日立
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     【摘要】目的:探讨化学发光法检测血清中总前列腺特异性抗原(t-PSA)及f-PSA/t-PSA比值在前列腺疾病诊断中的意义。方法:179名研究对象分成三组,健康对照组62人,BPH组76人,PCa组41人。用全自动化学发光免疫法分别测定它们的t-PSA、f-PSA,并计算f/t比值。然后进行统计学分析。结果:PCa组和BPH组血清t-PSA及f/t比值均有显著性差异(p﹤0.01)。当t-PSA在4.0-10.0ng/ml之间时,两组患者血清t-PSA无显著性差异(p>0.05)。但PCa组的f/t比值却显著低于BPH组的f/t比值(p﹤0.01)。结论:f/t比值作为t-PSA的辅助指标在诊断灰区能显著提高前列腺癌的鉴别诊断能力。

    【关键词】总前列腺特异性抗原;游离前列腺特异性抗原;F/T比值;前列腺癌;化学发光

    Diagnostic Application of Serum Free/total Prostate Specific Antigenin the Prostate Disease

    Luo Rili

    【Abstract】ObjectiveTo investigate the value of t-PSA and f/tPSA ratios measured by Chemiluminecent Microparticle Immunioassy (CMIA)for the detection of prostae disease .MethodsSerum samples were collected From 62 men without prostate disease ,76 patients with BPH and 41 patients with PCa. t-PSA, f-PSA were measured by an automated chemilluminescent microparticle immunoassay. Then, the ratio between t-PSA and f-PSA were calculated , the results were statistically analyzed . ResultsBoth total PSA and the ratio of free PSA to total PSA significantly differentiated between patients with PCa and patients with BPH (p﹤0.01). In men with total PSA values between 4.0 and 10.0ng/ml, the ratio of free PSA to total PSA significantly differentiated between patients with PCa and patients with BPH(p<0.01),but the total PSA has no significant difference (p﹥0.05).ConclusionThe ratio of free PSA to total PSA being an adjuvant marker of total PSA can significantly enhance the ability to distinguish BPH from prostate cancer in patients within the “gray zone”.

    【Key words】Total prostate specific antigen (t-PSA);Free prostate specific antigen (f-PSA);F/T ratio; Prostate Cancer; Chemiluminecent microparticle immunoassay.

    【中图分类号】R352【文献标识码】B【文章编号】1005-0515(2011)04-0009-01

    近年来,随着人口老龄化和饮食结构的调整,前列腺癌(Prostate Cancer,PCa)在中老年男性中的发病率呈上升趋势[1]。前列腺特异性抗原(Prostate specific antigen,PSA)是目前用于筛查PCa的有重要价值的标志物,但前列腺特异性抗原只有组织特异性而不具备肿瘤特异性,良性前列腺增生(Benign prostatic hyperplasia,BPH)、前列腺炎症、前列腺触诊后PSA水平也会增高。单纯以PSA的参考范围0-4.0ng/ml为标准筛选PCa,结果尚不能令人满意。因此许多基于PSA的检测项目被应用于临床研究,如游离前列腺特异性抗原(Free prostate specific antigen f-PSA)及其与总前列腺特异性抗原(Total prostate specific antigen,t-PSA)的比值(f/t比值)、PSA密度、PSA动态变化等 ......

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