van Dieijen-Visser M P, Delaere K P, Gijzen A H, Brombacher P J
Department of Clinical Chemistry, De Wever-Hospital, Heerlen, The Netherlands.
Clin Chim Acta. 1988 May 31;174(2):131-40. doi: 10.1016/0009-8981(88)90380-4.
Serum prostatic-specific antigen (PSA) and prostatic acid phosphatase (PAP) were determined simultaneously in 241 patients presented to the Urology Department. The patients consisted of 140 prostatic carcinoma patients (34 newly diagnosed and 106 previously treated) and 101 patients with benign prostatic hypertrophy (BPH). Prostatic acid phosphatase was measured by two different methods, an enzymatic method (PAP-EA, Boehringer) with tartrate inhibition and an immunoenzymetric assay (PAP-IEMA, Hybritech). The concentration of prostatic specific antigen in serum was measured using a recently introduced immunoradiometric assay (PSA-IRMA, Hybritech). Receiver operating characteristic curves were constructed to compare the diagnostic value of the different tests at different cutoff values. The diagnostic efficiencies of the PAP-EA and the PAP-IEMA appeared to be similar. A better diagnostic efficiency for PSA compared to PAP was found independent of the cutoff value. The upper-normal limit of 2.7 micrograms/l for PSA, as suggested by the manufacturer and mentioned in the literature introduces too many false-positive results. We therefore selected 10 micrograms/l as the upper-normal limit for PSA (sensitivity 57%, specificity 88%). Combined sensitivity found for PAP + PSA was 37% with a specificity of 97%. A literature survey is included to allow better comparison with data published elsewhere.
对241名泌尿外科就诊患者同时测定了血清前列腺特异性抗原（PSA）和前列腺酸性磷酸酶（PAP）。患者包括140例前列腺癌患者（34例新诊断患者和106例既往接受过治疗的患者）以及101例良性前列腺增生（BPH）患者。采用两种不同方法测定前列腺酸性磷酸酶，一种是酶法（PAP-EA，勃林格公司），有酒石酸盐抑制作用，另一种是免疫酶测定法（PAP-IEMA，Hybritech公司）。血清中前列腺特异性抗原的浓度采用最近推出的免疫放射测定法（PSA-IRMA，Hybritech公司）进行测定。构建了受试者工作特征曲线，以比较不同检测方法在不同临界值时的诊断价值。PAP-EA和PAP-IEMA的诊断效率似乎相似。发现PSA的诊断效率优于PAP，且与临界值无关。制造商建议并在文献中提及的PSA正常上限2.7微克/升会产生过多假阳性结果。因此，我们选择10微克/升作为PSA的正常上限（敏感性57%，特异性88%）。PAP + PSA的联合敏感性为37%，特异性为97%。纳入了文献综述以便与其他地方发表的数据进行更好的比较。
