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目的 探讨血清游离前列腺特异性抗原 (PSA)百分率在血清总PSA为 4～ 10ng/ml时对前列腺癌的诊断价值。方法 用化学发光法测定 98例总PSA为 4～ 10ng/ml的未治前列腺疾病患者血清游离PSA(f PSA) ,其中良性前列腺增生 80例 ,前列腺癌 18例 ,并计算其游离PSA百分率 (f/t PSA)。结果 总PSA为 4～10ng/ml时 ,前列腺癌组f/t PSA明显低于前列腺增生组 (P <0 .0 1)。以f/t PSA 0 .18和 0 .2 2为界值时 ,诊断前列腺癌的敏感度为 83.3%和 94 .4 % ,特异度为 75 .0 %和 6 3.8% ,阳性预测值为 4 2 .8%和 37.0 % ,阴性预测值为95 .2 %和 98.1%。结论 总PSA为 4～ 10ng/ml诊断盲区时 ,f/t PSA对诊断前列腺癌有较好的临床价值 ,以0 .2 2为界值的敏感度达 94 .4 % ,阴性预测值达 98.1%。
Objective To investigate the diagnostic value of the percentage of serum free prostate specific antigen (PSA) in prostate cancer when the total serum PSA is 4 ~ 10ng / ml. Methods The serum free PSA (f PSA) in 98 cases of prostate cancer with total PSA of 4 ~ 10 ng / ml was determined by chemiluminescence method. Among them, 80 cases of benign prostatic hyperplasia and 18 cases of prostate cancer were calculated. The percentage of free PSA / t PSA). Results When the total PSA was 4 ~ 10ng / ml, the f / t PSA in prostate cancer group was significantly lower than that in benign prostatic hyperplasia group (P <0.01). The sensitivity of diagnosis of prostate cancer was 83.3% and 94.4% with a specificity of 75.0% and 68.3% with a positive predictive value of 4 for f / t PSA 0.18 and 0.2 2, respectively 2 .8% and 37.0%, negative predictive value of 95.2% and 98.1%. Conclusions When the total PSA is 4 ~ 10ng / ml, the f / t PSA has a good clinical value in the diagnosis of prostate cancer, with a sensitivity of 94.2% and a negative predictive value of 98.1 %.