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目的 :探讨鉴别前列腺癌 (PCA)和前列腺特异抗原 (PSA)值增高的良性前列腺增生症 (BPH )判定方法 ,提高 PCA的诊断率及前列腺活检的阳性率。方法 :hybritech法测定 19例 PCA和 19例 BPH血清中结合 PSA(Act- PSA)、γ- sm(γ- sem inoprotein)水平 ,初步探讨 γ- sm/ Act- PSA界值。结果 :γ- sm/ Act- PSA平均值 :PCA组0 .70 5 ,BPH组 1.40 5 ,差异显著 (P <0 .0 0 1)。以 PSA>10 ng/ ml为诊断 PCA标准 ,敏感度为 78.9% ,特异度为73.7%。引入γ- sm/ Act- PSA界值 (1.0 )后 ,以 PSA>10 ng/ m l且γ- sm / Act- PSA<1.0为 PCA诊断标准 ,敏感度为 6 8.5 % ,特异度上升为 89.5 %。假阳性率 (误诊率 )下降为 10 .5 %。结论 :γ- sm/ Act- PSA与 PSA联合判定法对PCA和 PSA高值的 BPH具有较理想的鉴别诊断意义
Objective: To explore the method of judging the benign prostatic hyperplasia (BPH) of prostate cancer (PCA) and prostate specific antigen (PSA), and to improve the diagnostic rate of PCA and the positive rate of prostate biopsy. Methods: The levels of PSA-PSA and γ-sem in protein in 19 PCA and 19 BPH serum samples were determined by hybritech method. Results: The average value of γ-sm / Act-PSA was 0.705 in PCA group and 1.405 in BPH group (P <0.01). With PSA> 10 ng / ml for the diagnosis of PCA criteria, the sensitivity was 78.9% and the specificity was 73.7%. After introducing the threshold of γ-sm / Act-PSA (1.0), with PSA> 10 ng / ml and γ-sm / Act-PSA <1.0 as the diagnostic criteria for PCA, the sensitivity and specificity were 68.5% and 89.5% . False positive rate (misdiagnosis rate) decreased to 10.5%. Conclusion: The combination of γ-sm / Act-PSA and PSA has a better diagnostic value for PCH and BPH