α1-抗糜蛋白酶与前列腺特异性抗原的比值在前列腺癌诊断中与总前列腺特异性抗原的关系

Ratio of alpha 1-antichymotrypsin--prostate specific antigen to total prostate specific antigen in prostate cancer diagnosis.

作者信息

Lein M, Jung K, Elgeti U, Brux B, Sinha P, Schnorr D, Loening S A

机构信息

Department of Urology, University Hospital Charité, Humboldt University Berlin, Schumannstrasse 20/21, D-10098 Berlin, Germany.

出版信息

Anticancer Res. 2000 Nov-Dec;20(6D):4997-5001.

PMID:11326657

Abstract

OBJECTIVE

To evaluate the analytical performance and diagnostic utility of prostate specific antigen (PSA) bound to alpha 1-antichymotrypsin (ACT) in serum to improve the differentiation between benign prostatic hyperplasia (BPH) and prostate cancer (PCa).

METHODS

A total of 351 white men 21 to 88 years old were analysed. Serum concentration of tPSA, free PSA (fPSA) and ACT-PSA were measured in 163 untreated PCa patients (median age 66 years), 94 patients with histologically or clinically confirmed BPH (median age 65 years) and 94 men without prostate disease considered as controls (median age 54 years). The Elecsys system 2010 (Roche Diagnostics, Germany) was used for the determinations of tPSA and fPSA. The ACT-PSA assay is a new developed prototype on the ES system (Roche Diagnostics, Germany).

RESULTS

The ACT-PSA assay showed reliable data of analytical performance in comparison to established assays for tPSA and fPSA. The median concentrations of tPSA (PCa: 9.22 micrograms/L, BPH: 2.28 micrograms/L, controls: 0.99 microgram/L) and ACT-PSA (7.99 micrograms/L vs. 1.63 micrograms/L vs. 0.58 microgram/L) were significantly different, respectively. The median ratios of fPSA/tPSA (PCa: 12.3%, BPH: 25.4%), ACT-PSA/tPSA (90.5% vs. 66.6%) and fPSA/ACT-PSA (14.0% vs. 38.6%) were significantly different between PCa and BPH patients. Significant differences of ratios between BPH and controls were not observed. Receiver operating characteristics analysis (tPSA up to 20 micrograms/L) for discrimination between PCa and BPH showed that the ratios fPSA/tPSA (area under the curve: 0.861) and fPSA/ACT-PSA (0.847) were significantly different from tPSA (0.663), but ACT-PSA (0.733) alone and also the ratio of ACT-PSA/tPSA (0.780) were not significantly different from tPSA (0.663).

CONCLUSION

The ratio fPSA/tPSA showed the best discrimination between BPH and PCa. The single or additional determination of ACT-PSA to tPSA does not improve the differentiation between the two groups of patients.

摘要

目的

评估血清中与α1 -抗糜蛋白酶（ACT）结合的前列腺特异性抗原（PSA）的分析性能和诊断效用，以改善良性前列腺增生（BPH）和前列腺癌（PCa）之间的鉴别诊断。

方法

共分析了351名年龄在21至88岁之间的白人男性。对163例未经治疗的PCa患者（中位年龄66岁）、94例经组织学或临床确诊为BPH的患者（中位年龄65岁）以及94名无前列腺疾病的男性作为对照（中位年龄54岁），检测其血清总PSA（tPSA）、游离PSA（fPSA）和ACT - PSA浓度。使用Elecsys系统2010（德国罗氏诊断公司）测定tPSA和fPSA。ACT - PSA检测是在ES系统（德国罗氏诊断公司）上新开发的原型检测方法。

结果

与已建立的tPSA和fPSA检测方法相比，ACT - PSA检测显示出可靠的分析性能数据。tPSA（PCa：9.22微克/升，BPH：2.28微克/升，对照：0.99微克/升）和ACT - PSA（7.99微克/升对1.63微克/升对0.58微克/升）的中位浓度分别有显著差异。PCa和BPH患者之间fPSA/tPSA（PCa：12.3%，BPH：25.4%）、ACT - PSA/tPSA（90.5%对66.6%）和fPSA/ACT - PSA（14.0%对38.6%）的中位比值有显著差异。未观察到BPH与对照组之间比值的显著差异。用于区分PCa和BPH的受试者工作特征分析（tPSA高达20微克/升）表明，fPSA/tPSA（曲线下面积：0.861）和fPSA/ACT - PSA（0.847）的比值与tPSA（0.663）有显著差异，但单独的ACT - PSA（0.733）以及ACT - PSA/tPSA的比值（0.780）与tPSA（0.663）无显著差异。