Shih W J, Collins J, Mitchell B, Wierzbinski B
Department of Veterans Affairs Medical Center, Lexington, Kentucky 40511.
J Natl Med Assoc. 1994 Sep;86(9):667-70.
Prostatic specific antigen (PSA) and prostatic acid phosphatase (PAP) are the tumor markers for monitoring disease progression or improvement in patients with prostate adenocarcinoma. The clinical utility of PSA and PAP for early detection of prostate adenocarcinoma, however, requires distinction between prostate adenocarcinoma and prostate nodular hyperplasia. The serum PSA and PAP levels were measured in 20 men with histologically proven prostate adenocarcinoma and 28 men with histologically proven prostate nodular hyperplasia. Patients' blood samples were collected 1 to 7 days prior to the prostate examination, which included a rectal digital examination, transurethral resection, cytoscopy, and prostate biopsy. Sensitivity, specificity, and predictive values of positive and negative results for the discrimination of prostate adenocarcinoma from prostate nodular hyperplasia were 85%, 89%, 85%, and 29%, respectively, for serum PSA (cutoff level: 10 ng/mL) and 40%, 96%, 89%, and 69%, respectively, for serum PAP (cutoff level: 10 ng/mL). Results indicate that marked elevation of serum PSA suggests prostate adenocarcinoma and that serum PSA can discriminate prostate adenocarcinoma from prostate nodular hyperplasia better than serum PAP.
前列腺特异性抗原（PSA）和前列腺酸性磷酸酶（PAP）是监测前列腺腺癌患者疾病进展或改善情况的肿瘤标志物。然而，PSA和PAP用于前列腺腺癌早期检测的临床效用需要区分前列腺腺癌和前列腺结节增生。对20例经组织学证实为前列腺腺癌的男性和28例经组织学证实为前列腺结节增生的男性测量了血清PSA和PAP水平。在前列腺检查（包括直肠指检、经尿道切除术、膀胱镜检查和前列腺活检）前1至7天采集患者血样。血清PSA（临界值：10 ng/mL）区分前列腺腺癌与前列腺结节增生的阳性和阴性结果的敏感性、特异性及预测值分别为85%、89%、85%和29%，血清PAP（临界值：10 ng/mL）的分别为40%、96%、89%和69%。结果表明，血清PSA显著升高提示前列腺腺癌，且血清PSA区分前列腺腺癌与前列腺结节增生的能力优于血清PAP。
