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目的 探讨游离前列腺特异性抗原 (fPSA)与总前列腺特异性抗原 (tPSA)比值 (f tPSA)在tPSA为 4～ 10ng ml时对前列腺癌和良性前列腺增生 (BPH)鉴别的意义及其局限性。方法 对1998年 10月至 2 0 0 2年 10月接受诊治的 180例血清tPSA为 4～ 10ng ml的前列腺癌和BPH患者进行回顾性分析。经组织学证实 ,36例 (2 0 % )是前列腺癌 ,14 4例 (80 % )是BPH。血清中tPSA和fPSA通过酶免微粒子捕捉法测定。前列腺体积通过经腹壁超声测定。前列腺癌与BPH组间比较用t检验。采用Pearson相关系数分析前列腺体积与f tPSA之间的相关性。结果 前列腺癌患者的tPSA、f tPSA平均值分别是 6 75ng ml与 0 17;BPH患者则是 6 4 8ng ml和 0 2 5。两组患者的tPSA差异无显著意义 (P >0 0 5 ) ,而前列腺癌患者的f tPSA值显著低于BPH患者 (P <0 0 1)。此外 ,两组患者的前列腺体积与f tPSA均呈显著正相关 (前列腺癌组相关系数r=0 5 0 ,P <0 0 1;BPH组r=0 2 4 ,P <0 0 1)。在前列腺体积小于 4 0cm3,两组患者的f tPSA差异有显著意义 (P <0 0 5 ) ,当体积超过 4 0cm3,则差异无显著意义 (P >0 0 5 )。结论 f tPSA对tPSA在 4～ 10ng ml之间的前列腺癌和BPH的鉴别诊断有重要意义 ,但由于受前列腺体积的影响 ,只有在
Objective To investigate the significance and limitations of the differential diagnosis of prostate cancer and benign prostatic hyperplasia (BPH) when tPSA is 4 ~ 10 ng ml, and the ratio of free prostate specific antigen (fPSA) to total prostate specific antigen (tPSA). Methods A retrospective analysis was performed on 180 prostate cancer and BPH patients with serum tPSA of 4 ~ 10 ng ml who were treated from October 1998 to October 2002. Histologically confirmed that 36 cases (20%) of prostate cancer, 14 4 cases (80%) is BPH. Serum tPSA and fPSA were measured by enzyme particle free capture. Prostate volume was measured by transabdominal sonography. Prostate cancer and BPH compared with t test. The Pearson correlation coefficient was used to analyze the correlation between prostate volume and f tPSA. Results The mean values of tPSA and f tPSA in patients with prostate cancer were 6 75 ng ml and 0 17 respectively, while those in BPH patients were 6 48 ng ml and 0 2 5 respectively. There was no significant difference in tPSA between the two groups (P> 0.05), while the value of f tPSA in patients with prostate cancer was significantly lower than that in patients with BPH (P <0.01). In addition, there was a significant positive correlation between prostate volume and f tPSA in both groups (r = 0.05 for the prostate cancer group, P <0.01; r = 0.24 for the BPH group, P <0.01). There was a significant difference in f tPSA between the two groups when the prostate volume was less than 40 cm 3 (P 0 05). When the volume exceeded 40 cm 3, the difference was not significant (P 0 05). Conclusion f tPSA is of great importance in the differential diagnosis of prostate cancer and BPH with tPSA between 4 and 10 ng ml. However, due to the influence of prostate volume,