Irani J, Millet C, Levillain P, Doré B, Begon F, Aubert J
Department of Urology, Centre Hospitalier Universitaire La Milétrie, Poitiers, France.
Eur Urol. 1996;29(4):407-12. doi: 10.1159/000473788.
High concentrations of serum prostate-specific antigen (PSA) may be associated with the presence of benign prostatic hyperplasia or prostatitis. We investigated the serum-to-urinary PSA ratio in patients with or without prostate cancer to assess its efficacy in enhancing serum PSA specificity.
Patients presenting abnormal findings in digital rectal examination or documented prostate carcinoma were prospectively included in the study. A control group, with no evidence of prostate disease, hospitalized in the same time interval was included. Serum and urine PSA levels were measured in our laboratory with the Tandem R assay (Hybritech). Samples were drawn twice at 2-month intervals (M1 and M3).
Sixty-eight patients were included in the study divided into 27 cases of benign prostatic hyperplasia, 20 of prostate carcinoma, 10 of prostatitis and 11 patients in the control group. Serum and urine PSA levels were not correlated (r < or = 0.1). There was no significant difference in any group from M1 to M3 as regards urinary PSA (p > or = 0.15). Intergroup comparison showed significantly (p < or = 0.004) high urinary PSA (mean level +/- SEM 28.3 +/- 3.4 micrograms/mmol creatinine) only in the benign prostatic hyperplasia group, mean levels in the prostate carcinoma, prostatitis and control groups being 3.7 +/- 1.1, 11 +/- 2.9 and 5.2 +/- 0.9 micrograms/mmol creatinine, respectively. Differences in urinary PSA levels between the confined prostate carcinoma and benign prostatic hyperplasia groups (p = 0.0008) were further increased when considering the serum-to-urinary PSA ratio (p = 0.0003).
Our results suggest that the serum-to-urinary PSA ratio may be useful in distinguishing benign prostatic hyperplasia from prostate cancer.
血清前列腺特异性抗原（PSA）浓度升高可能与良性前列腺增生或前列腺炎的存在有关。我们研究了患有或未患前列腺癌患者的血清与尿液PSA比值，以评估其提高血清PSA特异性的效能。
前瞻性纳入直肠指检有异常发现或确诊为前列腺癌的患者。纳入同期住院且无前列腺疾病证据的对照组。我们实验室采用串联R检测法（Hybritech）测定血清和尿液PSA水平。样本每隔2个月采集两次（M1和M3）。
68例患者纳入研究，分为良性前列腺增生27例、前列腺癌20例、前列腺炎10例和对照组11例。血清和尿液PSA水平无相关性（r≤0.1）。从M1到M3，任何组的尿液PSA均无显著差异（p≥0.15）。组间比较显示，仅良性前列腺增生组尿液PSA显著升高（平均水平±标准误28.3±3.4微克/毫摩尔肌酐），前列腺癌、前列腺炎和对照组的平均水平分别为3.7±1.1、11±2.9和5.2±0.9微克/毫摩尔肌酐。考虑血清与尿液PSA比值时，局限性前列腺癌组与良性前列腺增生组之间尿液PSA水平的差异（p = 0.0008）进一步增大（p = 0.0003）。
我们的结果表明，血清与尿液PSA比值可能有助于区分良性前列腺增生和前列腺癌。
