Pagani F, Zambolin T, Bonora R, Panteghini M
1 Laboratorio Analisi Chimico-Cliniche, Spedali Civili, Università Brescia, Italy.
J Nucl Med Allied Sci. 1990 Oct-Dec;34(4 Suppl):85-7.
To compare the clinical usefulness of the measurement of prostatic acid phosphatase (PAP) and prostate-specific antigen (PSA) in serum of patients with prostatic carcinoma, we studied 128 patients with prostatic pathology, sixty (46.9%) of whom had prostatic cancer. Receiver-operating characteristics (ROC) curves were constructed and the underlying areas were calculated and compared to study clinical efficiency of the two markers regardless of the cutoff level selected. The area for PSA (0.90 +/- 0.30) was significantly higher (p less than 0.001) than that of PAP (0.71 +/- 0.05) showing that PSA was a better discriminator of the patients with or without prostatic cancer. The maximal clinical efficiency of the two tests at selected cutoff levels (0.8 U/L for PAP and 10 micrograms/L for PSA) was 0.787 and 0.883, respectively, confirming the superiority of PSA. However, the associated determination of the two markers improved the clinical specificity with no false-positive cases.
为比较前列腺癌患者血清中前列腺酸性磷酸酶（PAP）和前列腺特异性抗原（PSA）检测的临床实用性，我们研究了128例有前列腺病变的患者，其中60例（46.9%）患有前列腺癌。构建了受试者工作特征（ROC）曲线，并计算和比较了曲线下面积，以研究这两种标志物在不考虑所选临界值水平情况下的临床效率。PSA的曲线下面积（0.90±0.30）显著高于PAP（0.71±0.05）（p<0.001），表明PSA在区分有无前列腺癌患者方面表现更佳。在所选临界值水平（PAP为0.8 U/L，PSA为10μg/L）下，这两种检测的最大临床效率分别为0.787和0.883，进一步证实了PSA的优越性。然而，联合检测这两种标志物可提高临床特异性，且无假阳性病例。
