Lin W Y, Gu C J, Kao C H, Changlai S P, Wang S J
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan.
Neoplasma. 1996;43(2):103-5.
The purpose of this study is to establish the normal range of serum prostate-specific antigen (PSA) and to evaluate the influence of age in a population of healthy Chinese men. Subjects with PSA concentration of less than 4.0 ng/ml and normal digital rectal examination (DRE) or PSA level greater than 4.0 ng/ml and/or abnormal results of DRE with negative biopsy were defined as clinically free of prostate cancer. A total of 1008 men aged between 21 and 80 years of age fulfilled the criteria of establishing the upper limits for PSA levels. The population was grouped by age decades. The 95th percentile was determined as the upper limit of normal (reference range) for each 10-year age group for the serum PSA concentration. Our data showed that the upper limit of normal (95th percentile) for the serum PSA concentration increases with age. It is 1.92 ng/ml for men 21 to 30 years of age. 1.85 ng/ml for men 31 to 40 years of age, 2.59 ng/ml for men 41 to 50 years of age, 3.31 ng/ml for men 51 to 60 years of age, 5.03 ng/ml for men 61 to 70 years of age and 5.73 ng/ml for men 71 to 80 years of age. In conclusion, the serum PSA concentration is directly correlated with patient age. The age-specific reference ranges should be established so as to increase diagnostic specificity in older men and increase diagnostic sensitivity in younger men and then the PSA assay can become more efficient as a screening test for prostatic cancer.
本研究的目的是确定中国健康男性群体血清前列腺特异性抗原（PSA）的正常范围，并评估年龄的影响。PSA浓度低于4.0 ng/ml且直肠指检（DRE）正常，或PSA水平高于4.0 ng/ml和/或DRE结果异常但活检阴性的受试者被定义为临床上无前列腺癌。共有1008名年龄在21至80岁之间的男性符合确定PSA水平上限的标准。该人群按年龄十年分组。确定每个10岁年龄组血清PSA浓度的第95百分位数作为正常上限（参考范围）。我们的数据显示，血清PSA浓度的正常上限（第95百分位数）随年龄增长而增加。21至30岁男性为1.92 ng/ml，31至40岁男性为1.85 ng/ml，41至50岁男性为2.59 ng/ml，51至60岁男性为3.31 ng/ml，61至70岁男性为5.03 ng/ml，71至80岁男性为5.73 ng/ml。总之，血清PSA浓度与患者年龄直接相关。应建立年龄特异性参考范围，以提高老年男性的诊断特异性，增加年轻男性的诊断敏感性，从而使PSA检测作为前列腺癌筛查试验更有效。
