Christensson A, Björk T, Nilsson O, Dahlén U, Matikainen M T, Cockett A T, Abrahamsson P A, Lilja H
Department of Clinical Chemistry, University of Lund, Malmö General Hospital, Sweden.
J Urol. 1993 Jul;150(1):100-5. doi: 10.1016/s0022-5347(17)35408-3.
Prostate specific antigen (PSA) in serum has recently been shown to occur in complex with alpha 1-antichymotrypsin and as an approximately 30 kDa. noncomplexed molecular form. We characterized PSA by 3 different assays in samples from 144 patients with benign prostatic hyperplasia (BPH) and 121 with carcinoma of the prostate. One of these noncompetitive assays measured total PSA by detecting PSA complexed to serine proteinase inhibitors and the noncomplexed molecular form, a second measured only PSA in complex with alpha 1-antichymotrypsin, whereas a third detected the noncomplexed form. PSA in complex with alpha 1-antichymotrypsin was the predominant form in all patient sera. Noncomplexed PSA constituted a minor fraction that was significantly smaller in patients with untreated prostate cancer than in those with BPH (p < 0.0001). The proportion of noncomplexed PSA does not correlate to the serum concentration of PSA or that of alpha 1-antichymotrypsin. In men with a serum PSA concentration of less than 10 micrograms./l. the combination of assays measuring total PSA immunoreactivity, the noncomplexed molecular form and PSA in complex with alpha 1-antichymotrypsin may facilitate discrimination between prostate cancer and BPH.
血清中的前列腺特异性抗原（PSA）最近被证明以与α1 -抗糜蛋白酶结合的复合物形式存在，并且还以一种分子量约为30 kDa的非复合分子形式存在。我们用3种不同的检测方法对144例良性前列腺增生（BPH）患者和121例前列腺癌患者的样本中的PSA进行了表征。其中一种非竞争性检测方法通过检测与丝氨酸蛋白酶抑制剂结合的PSA复合物和非复合分子形式来测定总PSA，第二种方法仅测定与α1 -抗糜蛋白酶结合的PSA，而第三种方法检测非复合形式。与α1 -抗糜蛋白酶结合的PSA是所有患者血清中的主要形式。非复合PSA占一小部分，在未经治疗的前列腺癌患者中显著低于BPH患者（p < 0.0001）。非复合PSA的比例与血清PSA浓度或α1 -抗糜蛋白酶的浓度均无相关性。在血清PSA浓度低于10微克/升的男性中，测量总PSA免疫反应性、非复合分子形式以及与α1 -抗糜蛋白酶结合的PSA的检测方法组合可能有助于区分前列腺癌和BPH。
