目的探讨前列腺肿瘤指标在前列腺癌与非癌人群中的差异及特点,研究新旧肿瘤标记物的潜在临床价值及意义。方法按前列腺癌集中高发年龄区间,随机选取60~89岁的男性,分为A、B两组。A组为健康(非癌)对照人群,共225人,平均73.16(60~89)岁,均源于安徽马鞍山地区健康体检中心。所有人员以往无任何前列腺癌相关或可疑病史及家族史,血清总前列腺特异性抗原(t PSA)<4.00 ng/ml,直肠指检、彩超及磁共振等影像学检查无任何明显异常。B组资料均源于马鞍山地区住院及门诊患者,均为病理确诊后的临床前列腺癌患者,共43人,平均73.62(61~85)岁。t PSA最低4.12 ng/ml,最高超过100 ng/ml,平均(47.15±6.60)ng/ml。A、B两组均按10岁年龄段再分为三组,按照60~69岁、70~79岁及80~89岁的年龄区间分别划分为彼此对应的A1、A2、A3及B1、B2、B3组。结果非癌人群(A组)的t PSA及人前列腺游离特异性抗原(f PSA)显著低于前列腺癌(B组)水平(P均<0.00)。两组t PSA均数及曲线差距的倍数甚大,达59.81倍(67.59/1.13),提示t PSA鉴别癌与非癌的能力极强,而%f PSA差距最小。A组的人前列腺2型早期特异性抗原(p2PSA)、%p2PSA及前列腺健康指数(PHI)总体均数均明显大于B组(P均<0.01),%p2PSA在两组之间的差距高达61.74倍(47.54/0.77)而反超t PSA。按癌与非癌之间的肿瘤标记物差异倍数大小而排列,%p2PSA位列第一,t PSA第二,f PSA、PHI、%f PSA及p2PSA依次列第3至第6。结论由于%p2PSA与PHI在前列腺癌患者有显著下降的特征,尤以%p2PSA最有潜力成为以往PSA诊断体系的辅助新肿瘤标记物。必要时动态对比PSA及%p2PSA等肿瘤标记物的年龄变化曲线特征,将可能优于以往单一PSA诊断模式。 Objective To explore the differences and characteristics of prostate tumor markers in prostate cancer and non-cancer populations and to study the potential clinical value and significance of new and old tumor markers. Methods According to the age range of high incidence of prostate cancer, randomly selected men aged 60 to 89 years, divided into A, B two groups. A group of healthy (non-cancerous) control population, a total of 225 people, an average of 73.16 (60 to 89) years of age, all from the Ma On Shan area health examination center. All previous personnel without any prostate cancer related or suspected history and family history of serum total prostate-specific antigen (t PSA) <4.00 ng / ml, digital rectal examination, color Doppler ultrasound and MRI imaging examination without any obvious abnormalities. All the data in group B originated from inpatients and outpatients in Ma’anshan district, and all of them were clinical prostate cancer patients with pathological diagnosis, with an average of 73.62 (61-85) years old. The lowest t PSA was 4.12 ng / ml and the highest was over 100 ng / ml with an average of (47.15 ± 6.60) ng / ml. Groups A and B were further divided into three groups according to the age of 10, divided into A1, A2, A3 and B1 corresponding to each other according to the age range of 60-69, 70-79 and 80-89 respectively , B3 group. Results The levels of t PSA and f PSA in non-cancer patients (group A) were significantly lower than those in patients with prostate cancer (group B) (all P <0.00). The mean of t-PA and the difference of curve between the two groups were very high, reaching 59.81 times (67.59 / 1.13), suggesting that t PSA has strong ability of distinguishing cancer from non-cancer and the difference of% f PSA is the smallest. The total number of human prostate type 2 early antigen (p2PSA),% p2PSA and PHI in group A were significantly higher than those in group B (P <0.01), and the difference of% p2PSA between the two groups was as high as 61.74 Times (47.54 / 0.77) and overtake t PSA. The percentages of differentially expressed tumor markers between cancer and noncancerous were ranked as% p2 PSA, t PSA second, f PSA, PHI,% f PSA and p2 PSA followed by 3 to 6, respectively. Conclusion% p2PSA and PHI are significantly reduced in patients with prostate cancer. In particular,% p2PSA has the best potential as a new tumor marker for PSA diagnostic system in the past. Dynamic comparisons of age-variant curve characteristics of tumor markers such as PSA and% p2PSA, if necessary, may be superior to previous single PSA diagnostic modalities.