[1]钟兴祥,刘思平,郑吉祥,等.血清FPSA/TPSA值在前列腺癌鉴别诊断中的价值[J].国际放射医学核医学杂志,2010,34(3):161-164.
　ZHONG Xing-xiang,LIU Si-ping,ZHENG Ji-xiang,et al.The clinical valuation of serum FPSA/FPSA in the diagnosis of prostate cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(3):161-164.
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
34
期数:
2010年第3期
页码:
161-164
栏目:
临床核医学
出版日期:
1900-01-01

文章信息/Info

Title:
The clinical valuation of serum FPSA/FPSA in the diagnosis of prostate cancer
作者:
钟兴祥1;  刘思平2;  郑吉祥1;  王菊新1;  张小文1;  范鸿登1
1. 广东省梅州市人民医院核医学科, 514031;
2. 广东省梅州市人民医院泌尿外科, 514031
Author(s):
ZHONG Xing-xiang1;  LIU Si-ping2;  ZHENG Ji-xiang1;  WANG Ju-xin1;  ZHANG Xiao-wen1;  FAN Hong-deng1
Department of Nuclear Medicine, The People’s Hospital of Meizhou, Meizhou 514031, China
关键词:
前列腺肿瘤; 前列腺增生; 荧光免疫测定; 前列腺特异抗原; 诊断; 鉴别
Keywords:
Prostatic neoplasms; Prostatic hyperplasia; Fluoroimmunoassay; Prostate-specific antigen; Diagnosis; differential
分类号:
10.3760/cma.j.issn.1673-4114.2010.03.009
摘要:
目的 探讨血清中游离前列腺特异性抗原(FPSA)/总前列腺特异性抗原(TPSA)值在鉴别诊断前列腺癌中的临床价值.方法 选取良性前列腺增生患者115例、前列腺癌患者58例、排除前列腺疾病的门诊健康体检者60例,采用时间分辨荧光免疫分析法测定血清TPSA、FPSA及FPSA/TPSA值,进行统计学分析.结果 TPSA为4.0~45.5 μg/L时,良性前列腺增生患者和前列腺癌患者交叉重叠,在此区域内,两组患者数差异无统计学意义(t=1.76,P>0.05),而两组患者FPSA/TPSA值却有显著差异(t=2.74,P<0.05),具有较大的鉴别诊断价值.以FPSA/TPSA值≤0.15作为鉴别诊断前列腺癌的参考值,既保持了较高的灵敏度(91.5%),又提高了特异度(78.6%)和准确率(79.8%),并在一定程度上提高了阳性预测值(82.5%)和阴性预测值(96.5%).结论 FPSA/TPSA值不但能够弥补单用TPSA的不足,提高前列腺癌的早期检出率,同时减少不必要的活检,值得进一步推广应用.
Abstract:
Objective To explore the clinical valuation of serum free prostate-specific antigen/total prostate-specific antigen (FPSA/TPSA) ratio in the diagnosis of prostate cancer with time-resolved fluoroimmunoassay. Methods Selected randomly 115 patients with benign prostatic hyperplasia and 58 patients with prostate cancer, sixty healthy physical examinees were chosen as normal control. Serum TPSA, FPSA and FPSA/TPSA ratio were measured with time-resolved fluoroimmunoassay. Results When TPSA was between 4.0-45.5 μg/L,there was the rang of overlapping of TPSA in benign prostatic hyperplasia and prostate cancer patients. TPSA couldn’t be a differential mark for the two conditions (t=1.76, P>0.05). But there were significant differences in the FPSA/TPSA ratio between the two conditions (t=2.74, P<0.05). When the reference value was FPSA/TPSA ≤0.15 in differential diagnosis of prostate cancer, it maintained a high sensitivity (91.5%), improved specificity (78.6%) and reliability (79.8%). It also improved positive predictive value (82.5%) and negative predictive value (96.5%) to a certain extent. Conclusions FPSA/TPSA ratio could make up for the shortage of only TPSA and improved the early detection rate of prostate cancer. It also reduced unnecessary biopsy and worth popularizing.

参考文献/References:

[1] Crawford ED. Epidmiology of prostate cancer. Urology, 2003, 62(6 Suppl 1):3-12.
[2] LuKes M, Urban M, Zalesky M, et al. Prostate-specific antigen:current status. Folia Biol (Praha), 2001,47(2):41-49.
[3] Cartledge JJ, Thompson D, Verril H, et al. The stability of free and bound prostate-specific antigen. BJU Int, 1999, 84(7):810-814.
[4] 托马斯.临床实验诊断学:实验结果的应用和评估.上海:上海科学技术出版社,2004:960-961.
[5] Caplan A, Kralz A, Prostate-specific antigen ami the early diagnosis of prostate cancer. Am J Clin Pathol, 2002, 117(suppl):S104-S108.
[6] 张晓春,那彦群,郭应禄.前列腺特异性抗原普査在诊断前列腺癌中的作用.中华泌尿外科杂志,2000,21(〖):37~40.
[7] Stenman UH, Leinonen J, Alfthan H. A complex between prostate-specific antigen and alphal-antirhymotrypsin is the major form of prostate-specific antigen in serum of patients with prostatic cancer assays of the complex improves clinical sensitivity for cancer. Cancer Res, 1991,51(l):222-226.

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备注/Memo

备注/Memo:
收稿日期:2010-01-17。
通讯作者:钟兴祥(E-mail:zhxx.htyy@l63.com)
更新日期/Last Update: 1900-01-01