Imai K, Suzuki T, Kuribara J, Ito K, Ootake N, Hatori M, Yamanaka H, Tomaru Y, Jinbo S, Kiren H
Department of Urology, Gunma University Medical School.
Nihon Hinyokika Gakkai Zasshi. 1992 Sep;83(9):1484-9. doi: 10.5980/jpnjurol1989.83.1484.
The significance of prostatic specific antigen (PSA) was investigated in the subjects examined by the mass screening for prostate cancer from 1985 to 1990. All subjects was examined by digital rectal examination (DRE) and with prostatic acid phosphatase (PAP) and the subjects in whom prostate cancer (Pca) was suspected from abnormal DRE and/or elevated PAP were recommended to receive the secondary screening to confirm the presence of Pca. PSA was measured by radioimmunoassay using Ball-Elsa-PSA-kit. 1,600 serum samples were obtained from our serum bank. The relationship among PSA, prostate size estimated by DRE and age was investigated. PSA was increased with age and the prostate size, PSA being more closely related with the latter. Therefore, we estimated that PSA has an ability to detect benign prostatic hypertrophy (BPH) in the mass screening. This estimation should be confirmed by using an ultrasound tomography because the prostate size obtained by DRE is inaccurate as compared with that obtained by ultrasound tomography. The cut off level of PSA was determined by control which was composed from the subjects with normal size prostate and one with BPH. When the cut off level was 8.6 ng/ml, the sensitivity, specificity and efficiency as Pca marker was 73.9%, 97.4% and 97.1%, respectively. PSA was more than 8.6 ng/ml in all of Pca with elevated PAP. PSA was expected to improve the Pca detection rate in our mass screening system.
对1985年至1990年接受前列腺癌大规模筛查的受试者中前列腺特异性抗原（PSA）的意义进行了研究。所有受试者均接受了直肠指检（DRE）以及前列腺酸性磷酸酶（PAP）检测，对于直肠指检异常和/或前列腺酸性磷酸酶升高而怀疑患有前列腺癌（Pca）的受试者，建议接受二次筛查以确认是否存在前列腺癌。使用Ball-Elsa-PSA试剂盒通过放射免疫分析法测定PSA。从我们的血清库中获取了1600份血清样本。研究了PSA、通过直肠指检估计的前列腺大小与年龄之间的关系。PSA随年龄和前列腺大小增加，且与后者的关系更为密切。因此，我们估计PSA在大规模筛查中有检测良性前列腺增生（BPH）的能力。这一估计应通过超声断层扫描来证实，因为与超声断层扫描获得的前列腺大小相比，直肠指检获得的前列腺大小不准确。PSA的临界值由前列腺大小正常的受试者和良性前列腺增生受试者组成的对照组确定。当临界值为8.6 ng/ml时，作为前列腺癌标志物的敏感性、特异性和效率分别为73.9%、97.4%和97.1%。所有前列腺酸性磷酸酶升高的前列腺癌患者的PSA均超过8.6 ng/ml。预计PSA将提高我们大规模筛查系统中前列腺癌的检出率。
