在中国西部，总 PSA 水平在 2.0-25.0ng/ml 之间的 50 岁以上男性，游离/总 PSA 比值在前列腺癌诊断中的临床应用。
Clinical application of free/total PSA ratio in the diagnosis of prostate cancer in men over 50 years of age with total PSA levels of 2.0-25.0 ng ml in Western China.
机构信息
Department of Laboratory Medicine/Research Center of Clinical Laboratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China.
Department of Laboratory Medicine, Nan'an Chinese Medicine Hospital, Chongqing 400060, China.
出版信息
Asian J Androl. 2022 Mar-Apr;24(2):195-200. doi: 10.4103/aja202182.
The goal of this study was to investigate the clinical application of free/total prostate-specific antigen (F/T PSA) ratio, considering the new broad serum total PSA (T-PSA) "gray zone" of 2.0-25.0 ng ml in differential diagnosis of prostate cancer (PCa) and benign prostate diseases (BPD) in men over 50 years in Western China. A total of 1655 patients were included, 528 with PCa and 1127 with BPD. Serum T-PSA, free PSA (F-PSA), and F/T PSA ratio were analyzed. Receiver operating characteristic curves were used to assess the efficiency of PSA and F/T PSA ratio. There were 47.4% of cancer patients with T-PSA of 2.0-25.0 ng ml. When T-PSA was 2.0-4.0 ng ml, 4.0-10.0 ng ml, and 10.0-25.0 ng ml, the area under the curve (AUC) of F/T PSA ratio was 0.749, 0.769, and 0.761, respectively. The best AUC of F/T PSA ratio was 0.811 when T-PSA was 2.0-25.0 ng ml, with a specificity of 0.732, a sensitivity of 0.788, and an optimal cutoff value of 15.5%. The AUC of F/T PSA ratio in different age groups (50-59 years, 60-69 years, 70-79 years, and ≥80 years) was 0.767, 0.806, 0.815, and 0.833, respectively, and the best sensitivity (0.857) and specificity (0.802) were observed in patients over 80 years. The T-PSA trend was in accordance with the Gleason score, tumor node metastasis (TNM) stage, and American Joint Committee on Cancer prognosis group. Therefore, the F/T PSA ratio can facilitate the differential diagnosis of PCa and BPD in the broad T-PSA "gray zone". Serum T-PSA can be a Gleason score and prognostic indicator.
本研究旨在探讨游离/总前列腺特异性抗原（F/T PSA）比值在诊断中国西部 50 岁以上男性前列腺癌（PCa）和良性前列腺疾病（BPD）中的临床应用，考虑到新的血清总 PSA（T-PSA）“灰区”为 2.0-25.0ng/ml。共纳入 1655 例患者，其中 PCa 患者 528 例，BPD 患者 1127 例。分析血清 T-PSA、游离 PSA（F-PSA）和 F/T PSA 比值。采用受试者工作特征曲线评估 PSA 和 F/T PSA 比值的效率。有 47.4%的癌症患者 T-PSA 为 2.0-25.0ng/ml。当 T-PSA 为 2.0-4.0ng/ml、4.0-10.0ng/ml 和 10.0-25.0ng/ml 时，F/T PSA 比值的曲线下面积（AUC）分别为 0.749、0.769 和 0.761。当 T-PSA 为 2.0-25.0ng/ml 时，F/T PSA 比值的最佳 AUC 为 0.811，特异性为 0.732，灵敏度为 0.788，最佳截断值为 15.5%。在不同年龄组（50-59 岁、60-69 岁、70-79 岁和≥80 岁）中，F/T PSA 比值的 AUC 分别为 0.767、0.806、0.815 和 0.833，80 岁以上患者的最佳灵敏度（0.857）和特异性（0.802）最高。T-PSA 趋势与 Gleason 评分、肿瘤淋巴结转移（TNM）分期和美国癌症联合委员会预后组一致。因此，F/T PSA 比值有助于在广泛的 T-PSA“灰区”中鉴别诊断 PCa 和 BPD。血清 T-PSA 可以作为 Gleason 评分和预后指标。
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