Imai K, Watanabe K, Higashi H, Shinya H, Okamura K, Matsuo Y, Yazima H, Takezawa Y, Yamanaka H
Hinyokika Kiyo. 1993 Sep;39(9):807-12.
The significance of prostate specific antigen (PSA) measured by DELFIA PSA kit in the 1,177 serum samples examined by mass screening for prostate cancer was evaluated. All subjects were examined by questionnaire, digital rectal examination (DRE) and prostatic acid phosphatase (PAP) and the subjects in whom prostate cancer was suspected from abnormal DRE and/or elevated PAP were recommended to receive the secondary screening for the presence of prostate cancer. All serum specimens used for this study were kept in our serum bank. The cut-off value was investigated between non-cancer subjects (diagnosed as normal, voiding disturbance or BPH) and prostate cancer patients. When the cut-off value was 2.89 ng/ml, the sensitivity, specificity and accuracy as prostate marker was 80.6%, 90.0% and 89.4%, respectively. Therefore, the cut-off value was determined as 3.0 ng/ml. The significance of PSA was retrospectively evaluated compared to PAP in the subjects examined by our mass screening. Twenty eight of the 39 palpable prostate cancers which could not be detected from the PAP level were detected from the PSA level, namely the sensitivity of the detection using the PSA level is more excellent than that using PAP. However, the false negative rate obtained using PSA was high (30.3%) in the patients with stage B disease. The relationship among serum PSA concentration, prostate size estimated by DRE and age was investigated. PSA was increased with age and prostate size. This estimation should be confirmed by using an ultrasonography because the prostate size obtained by DRE is inaccurate as compared with that obtained by ultrasonography.
评估了通过DELFIA PSA试剂盒检测的前列腺特异性抗原（PSA）在1177份通过前列腺癌大规模筛查检测的血清样本中的意义。所有受试者均通过问卷调查、直肠指检（DRE）和前列腺酸性磷酸酶（PAP）进行检查，对于因DRE异常和/或PAP升高而怀疑患有前列腺癌的受试者，建议进行前列腺癌二次筛查。本研究使用的所有血清标本均保存在我们的血清库中。研究了非癌症受试者（诊断为正常、排尿障碍或良性前列腺增生）与前列腺癌患者之间的临界值。当临界值为2.89 ng/ml时，作为前列腺标志物的敏感性、特异性和准确性分别为80.6%、90.0%和89.4%。因此，临界值确定为3.0 ng/ml。在我们的大规模筛查中，将PSA与PAP进行了回顾性比较，评估了PSA的意义。在39例可触及的前列腺癌中，有28例通过PAP水平无法检测到，但通过PSA水平检测到了，也就是说，使用PSA水平检测的敏感性比使用PAP检测的敏感性更高。然而，B期疾病患者使用PSA获得的假阴性率较高（30.3%）。研究了血清PSA浓度、通过DRE估计的前列腺大小与年龄之间的关系。PSA随年龄和前列腺大小增加。由于与超声检查获得的前列腺大小相比，通过DRE获得的前列腺大小不准确，因此应通过超声检查来确认这种估计。
