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游离、复合及总前列腺特异性抗原的各种组合用于检测前列腺癌的比较。

Comparisons of the various combinations of free, complexed, and total prostate-specific antigen for the detection of prostate cancer.

作者信息

Okegawa T, Noda H, Nutahara K, Higashihara E

机构信息

Department of Urology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.

出版信息

Eur Urol. 2000 Oct;38(4):380-7. doi: 10.1159/000020312.

DOI:10.1159/000020312
PMID:11025374
Abstract

OBJECTIVES

We compared the ability of three prostate-specific antigen (PSA) ratios - free-to- total PSA ratio (fPSA/tPSA), free-to-complexed PSA ratio (fPSA/cPSA), and complexed-to-total PSA ratio (cPSA/tPSA) - to distinguish prostate cancer from benign prostatic hyperplasia (BPH).

METHODS

We tested 258 consecutive patients who underwent transrectal ultrasound-guided prostate needle biopsy because of an abnormal digital rectal examination or a Tandem-R PSA of >4.1 ng/ml. Free PSA (fPSA) and total PSA (tPSA) were measured by Tandem-R assay. alpha(1)-Antichymotrypsin-complexed PSA (cPSA) was measured by Markit-M PSA-ACT assay.

RESULTS

Of the 258 patients, 204 had BPH, and 54 had prostate cancer. The specificity at 96% sensitivity for fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA was 23, 25, and 33%, respectively. Of 162 patients with tPSA between 4.1 and 10.0 ng/ml, 132 had BPH and 30 had prostate cancer. The specificity at 96% sensitivity for f/tPSA, f/cPSA and c/tPSA was 32, 44, and 41%, respectively. There was no significant difference in the area under the receiver-operating characteristic curves among fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA in the overall PSA range or in tPSA between 4.1 and 10.0 ng/ml.

CONCLUSION

fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA did not differ in their ability to distinguish prostate cancer from BPH.

摘要

目的

我们比较了三种前列腺特异性抗原（PSA）比值——游离PSA与总PSA比值（fPSA/tPSA）、游离PSA与复合PSA比值（fPSA/cPSA）以及复合PSA与总PSA比值（cPSA/tPSA）——区分前列腺癌与良性前列腺增生（BPH）的能力。

方法

我们对258例因直肠指检异常或串联R法检测总PSA（Tandem-R PSA）>4.1 ng/ml而接受经直肠超声引导下前列腺穿刺活检的连续患者进行了检测。游离PSA（fPSA）和总PSA（tPSA）采用串联R法检测。α1-抗糜蛋白酶复合PSA（cPSA）采用Markit-M PSA-ACT法检测。

结果

258例患者中，204例患有BPH，54例患有前列腺癌。fPSA/tPSA、fPSA/cPSA和cPSA/tPSA在96%灵敏度时的特异性分别为23%、25%和33%。在162例tPSA为4.1至10.0 ng/ml的患者中，132例患有BPH，30例患有前列腺癌。f/tPSA、f/cPSA和c/tPSA在96%灵敏度时的特异性分别为32%、44%和41%。在整个PSA范围内或tPSA为4.1至10.0 ng/ml时，fPSA/tPSA、fPSA/cPSA和cPSA/tPSA的受试者操作特征曲线下面积无显著差异。

结论

fPSA/tPSA、fPSA/cPSA和cPSA/tPSA在区分前列腺癌与BPH的能力上没有差异。

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