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目的探讨血清游离前列腺特异性抗原(fPSA)和总前列腺特异性抗原(tPSA)及其比值(f/tPSA)对良性前列腺增生(BPH)与前列腺癌(PCa)鉴别诊断的临床价值。方法应用电化学发光法检测fPSA与tPSA并计算两者比值f/tPSA;计算不同f/tPSA对应的敏感性和特异性。结果虽然各指标在PCa与BPH组间存在显著性差异,但在4～10 ng/ml的诊断灰区,tPSA的PCa组(7.93±1.38)与BPH组(7.12±1.59)间无显著性差异(P>0.05),fPSA的PCa组(1.12±0.39)与BPH组(1.36±0.48)间也无显著性差异(P>0.05),而f/tPSA的PCa组(0.11±0.04)和BPH组(0.27±0.07)间有非常显著性差异(P<0.001)。结论在诊断灰区,用f/tPSA比值鉴别诊断前列腺癌比tPSA更有价值,以f/tPSA<0.16为诊断鉴别点比较适当。
Objective To investigate the clinical value of serum free prostate-specific antigen (fPSA) and total prostate-specific antigen (tPSA) and its ratio (f / tPSA) in the differential diagnosis of benign prostatic hyperplasia (BPH) and prostate cancer (PCa) Methods The chemiluminescence method was used to detect fPSA and tPSA, and the ratio f / tPSA was calculated. The sensitivity and specificity of different f / t PSA were calculated. Results Although there was a significant difference between PCa and BPH groups, no significant difference was found in the diagnostic gray zone of 4 ~ 10 ng / ml, the PCa group of tPSA (7.93 ± 1.38) and the BPH group (7.12 ± 1.59) (P> 0.05). There was also no significant difference between fPSA PCa group (1.12 ± 0.39) and BPH group (1.36 ± 0.48) (P> 0.05), while f / tPSA PCa group (0.11 ± 0.04) (0.27 ± 0.07), there was a significant difference (P <0.001). Conclusion In the diagnosis of gray areas, the differential diagnosis of prostate cancer with f / tPSA ratio is more valuable than tPSA, f / tPSA <0.16 for the diagnosis of more appropriate.