用于改善伊朗人群中前列腺癌与良性前列腺增生鉴别诊断的游离前列腺特异性抗原与总前列腺特异性抗原比值的准确临界值。

Accurate cut-off point for free to total prostate-specific antigen ratio used to improve differentiation of prostate cancer from benign prostate hyperplasia in Iranian population.

作者信息

Amirrasouli Houshang, Kazerouni Faranak, Sanadizade Mohammad, Sanadizade Javad, Kamalian Nasser, Jalali Mohammadtaha, Rahbar Khosro, Karimi Kamran

机构信息

Department of Laboratory Medicine, Faculty of Paramedical Sciences, Shahid Beheshti University, MC, Tehran, Iran.

出版信息

Urol J. 2010 Jun 10;7(2):99-104.

PMID:20535696

Abstract

PURPOSE

Our aim was to determine a more predictive cut-off value for free to total prostate-specific antigen ratio (f/tPSA) to better differentiate prostate cancer (PCa) from benign prostate hyperplasia (BPH) in Iranian patients with serum PSA levels between 4 and 20 ng/mL.

MATERIALS AND METHODS

This study was performed on 332 men with serum tPSA level of 4 to 20 ng/mL. All patients underwent transrectal ultrasound guided biopsies. Serum levels of tPSA and fPSA were measured by Roche immunoassay Elecsys 2010. Relationship between f/tPSA and cases of PCa was determined.

RESULTS

Prostate cancer detected in 49 (15%) patients. Incidence of PCa for serum tPSA level < 10 ng/mL and serum tPSA level of 10.1 to 20 ng/ mL was 17 (6.7%) and 32 (39.5%), respectively. Mean f/tPSA value was significantly lower in PCa patients (0.12 +/- 0.01) than in benign histology group (0.16 +/- 0.03). Among patients with serum PSA level of 4 to 10 ng/mL (n = 251), mean f/tPSA in benign histology group (n = 234) was 0.16 +/- 0.08 and in PCa group (n = 17) was 0.13 +/- 0.06 (P < .05). For serum PSA level of 10.1 to 20 ng/mL (n = 81), mean f/tPSA in benign histology group (n = 49) was 0.16 +/- 0.08 and in PCa group (n = 32) was 0.12 +/- 0.05 (P < .05). The cut-off value of 0.12 produced 76% sensitivity and 71% specificity, whereas the cut-off value of 0.14 yielded 83.5% sensitivity and 61% specificity.

CONCLUSION

Determination of f/tPSA ratio improves differentiation of Pca from BPH. We recommend a cut-off value of 0.14 to be applied to Iranian patients.

摘要

目的

我们的目的是确定游离前列腺特异性抗原与总前列腺特异性抗原比值（f/tPSA）更具预测性的临界值，以便在血清PSA水平为4至20 ng/mL的伊朗患者中更好地区分前列腺癌（PCa）和良性前列腺增生（BPH）。

材料与方法

本研究对332名血清总PSA（tPSA）水平为4至20 ng/mL的男性进行。所有患者均接受经直肠超声引导下活检。采用罗氏免疫分析系统Elecsys 2010检测血清tPSA和fPSA水平。确定f/tPSA与PCa病例之间的关系。

结果

49例（15%）患者检测出前列腺癌。血清tPSA水平<10 ng/mL和血清tPSA水平为10.1至20 ng/mL时，PCa的发生率分别为17例（6.7%）和32例（39.5%）。PCa患者的平均f/tPSA值（0.12±0.01）显著低于良性组织学组（0.16±0.03）。在血清PSA水平为4至10 ng/mL的患者（n = 251）中，良性组织学组（n = 234）的平均f/tPSA为0.16±0.08，PCa组（n = 17）为0.13±0.06（P <.05）。对于血清PSA水平为10.1至20 ng/mL的患者（n = 81）,良性组织学组（n = 49）的平均f/tPSA为0.16±0.08，PCa组（n = 32）为0.12±0.05（P <.05）。临界值为0.12时，敏感性为76%，特异性为71%；而临界值为0.14时，敏感性为83.5%，特异性为61%。