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目的探讨血清前列腺特异性抗原(PSA)增高在老年男性前列腺疾病中的临床意义。方法对96例临床检测血清PSA>4ng/ml老年男性患者前列腺按病理诊断分为3组:良性前列腺增生(BPH)47例、前列腺癌前病变(PPC)23例、前列腺癌(PCa)26例。经直肠B超检测前列腺体积,分析各组患者血清PSA、游离PSA与血清PSA比值(FPSA/PSA)、PSA密度(PSAD)等计量资料以及分区域计数资料与病理诊断结果关系。结果各组患者血清PSA、FPSA/PSA、PSAD差异有统计学意义(P<0.01,P<0.05);将患者按PSA、PSAD、FPSA/PSA值大小分区,各组患者在各区间人数分布差异有统计学意义(P<0.01);按血清PSA>20ng/ml并FPSA/PSA<0.25、PSA为10～20ng/ml并FPSA/PSA<0.15标准判断PCa,特异性为66.7%,灵敏度为85.7%。结论PSA是早期诊断PCa的重要线索,结合FPSA/PSA比值对早期诊断PCa有较大意义,PSAD可以作为PCa早期诊断的辅助指标。
Objective To investigate the clinical significance of elevated serum prostate-specific antigen (PSA) in elderly men with prostate disease. Methods Ninety-six elderly men with serum PSA> 4ng / ml were divided into three groups according to their pathological diagnosis: 47 cases of benign prostatic hyperplasia (BPH), 23 cases of precancerous lesions (PPC), 26 cases of prostate cancer (PCa) . Prostate volume was measured by transrectal ultrasound B, the serum PSA, free PSA to serum PSA ratio (FPSA / PSA), PSA density (PSAD) measurement data and subarea count data were analyzed in relation to pathological diagnosis results. Results The serum PSA, FPSA / PSA and PSAD in each group were significantly different (P <0.01, P <0.05). The patients were divided into groups according to the PSA, PSAD and FPSA / PSA values. (P <0.01). The specificity of PCa was 66.7% with a sensitivity of 85.7% for serum PSA> 20ng / ml and FPSA / PSA <0.25, PSA 10-20ng / ml and FPSA / PSA < %. Conclusions PSA is an important clue for the early diagnosis of PCa. Combining the FPSA / PSA ratio is of great significance in the early diagnosis of PCa. PSAD can be used as an auxiliary indicator of early diagnosis of PCa.