Kaplan L A, Chen I W, Sperling M, Bracken B, Stein E A
Am J Clin Pathol. 1985 Sep;84(3):334-9. doi: 10.1093/ajcp/84.3.334.
Serum prostatic acid phosphatase (PAP), measured by three different technics, was used to screen 560 men over 50 years of age for prostatic cancer. All three PAP procedures failed to detect the one subject found to have prostatic cancer on physical examination and confirmed by biopsy, and all assays had a significant number of "falsely" elevated PAP levels. Four PAP assays were assessed in 80 men undergoing prostatic biopsy/removal in whom histologic examination of prostatic tissue was made. Clinical sensitivity and specificity for detecting those patients with and without prostatic cancer ranged from 20-57% and 54-95%, respectively, with the monoclonal enzyme immunoassay being the most sensitive but the least specific, and the traditional enzyme assay being the most specific but insensitive. In men with diagnosed prostatic cancer undergoing radiation or chemotherapy, the assays were useful in distinguishing between those with active and inactive disease. The authors conclude that serum PAP assays, irrespective of the type of procedure used, has no place in screening for prostatic cancer, a minimal role in establishing a definitive diagnosis, but a useful role in monitoring therapy.
采用三种不同技术检测血清前列腺酸性磷酸酶（PAP），对560名50岁以上男性进行前列腺癌筛查。所有三种PAP检测方法均未检测出经体格检查发现并经活检确诊患有前列腺癌的那名受试者，且所有检测均有大量“假性”升高的PAP水平。对80名接受前列腺活检/切除且对前列腺组织进行了组织学检查的男性进行了四种PAP检测。检测患有和未患有前列腺癌患者的临床敏感性和特异性分别为20% - 57%和54% - 95%，其中单克隆酶免疫测定法最敏感但特异性最低，传统酶测定法最具特异性但不敏感。在已确诊前列腺癌并接受放疗或化疗的男性中，这些检测方法有助于区分疾病处于活动期和非活动期的患者。作者得出结论，血清PAP检测，无论使用何种检测方法，在前列腺癌筛查中均无作用，在明确诊断方面作用极小，但在监测治疗方面具有有用作用。
