Nakashima J, Nagata H, Sumitomo M, Miyajima A, Tachibana M, Baba S, Jitsukawa S, Murai M
Department of Urology, Keio University School of Medicine, Tokyo, Japan.
Int J Urol. 1999 Jun;6(6):298-304. doi: 10.1046/j.1442-2042.1999.00063.x.
The present study was undertaken to investigate the value of gamma-seminoprotein (gamma-Sm) and the gamma-Sm/prostate specific antigen (PSA) ratio in combination with serum PSA in detecting prostate cancer.
Prostate specific antigen, gamma-Sm and the gamma-Sm/PSA ratio were evaluated in 112 patients with untreated prostate cancer and 90 patients without prostate cancer who had serum PSA and gamma-Sm levels above their respective detection limits.
When data for all of the patients were analyzed, serum PSA and gamma-Sm levels were significantly higher and the gamma-Sm/PSA ratio was significantly lower in patients with prostate cancer than patients without prostate cancer. The serum PSA and gamma-Sm levels significantly increased and the gamma-Sm/PSA ratio significantly decreased with advancing clinical stage in patients with prostate cancer. Among the patients with serum PSA levels ranging from 1.8 to 6 ng/mL, the gamma-Sm/PSA ratio was significantly lower (P < 0.05) and gamma-Sm levels were lower (P = 0.054) in the patients with prostate cancer than in those without prostate cancer, but serum PSA levels were not significantly different (P = 0.53). A receiver operating characteristic (ROC) analysis demonstrated that the areas under the ROC curves were 0.54 for PSA, 0.65 for gamma-Sm and 0.69 for the gamma-Sm/PSA ratio for prediction of prostate cancer in the PSA range from 1.8 to 6 ng/mL, although the ROC analysis suggested that the gamma-Sm/PSA ratio does not provide significant advantage over PSA in detecting prostate cancer when all of the patients were analyzed.
These results suggest that the gamma-Sm/PSA ratio and gamma-Sm may facilitate differentiation between patients with and without prostate cancer who have intermediate PSA levels.
本研究旨在探讨γ-精浆蛋白（γ-Sm）及γ-Sm/前列腺特异性抗原（PSA）比值联合血清PSA在前列腺癌检测中的价值。
对112例未经治疗的前列腺癌患者和90例无前列腺癌患者进行了评估，这些患者的血清PSA和γ-Sm水平均高于各自的检测限。
分析所有患者的数据时发现，前列腺癌患者的血清PSA和γ-Sm水平显著更高，而γ-Sm/PSA比值显著更低。前列腺癌患者中，随着临床分期的进展，血清PSA和γ-Sm水平显著升高，γ-Sm/PSA比值显著降低。在血清PSA水平为1.8至6 ng/mL的患者中，前列腺癌患者的γ-Sm/PSA比值显著更低（P < 0.05），γ-Sm水平更低（P = 0.054），但血清PSA水平无显著差异（P = 0.53）。受试者工作特征（ROC）分析表明，在PSA范围为1.8至6 ng/mL时，用于预测前列腺癌的ROC曲线下面积，PSA为0.54，γ-Sm为0.65，γ-Sm/PSA比值为0.69，尽管ROC分析表明，分析所有患者时，γ-Sm/PSA比值在检测前列腺癌方面并不比PSA具有显著优势。
这些结果表明，γ-Sm/PSA比值和γ-Sm可能有助于鉴别PSA水平处于中等范围的前列腺癌患者和非前列腺癌患者。
