Van Cangh P J, De Nayer P, Sauvage P, Tombal B, Elsen M, Lorge F, Opsomer R, Wese F X
Department of Urology, Saint Luc University Hospital, Brussels, Belgium.
Prostate Suppl. 1996;7:30-4.
Serum prostate-specific antigen (PSA) exists in different molecular forms, and their respective concentration has been proposed as a useful tool to improve discrimination between benign prostatic hypertrophy (BPH) and prostate cancer (PC).
The relevance of the free to total PSA ratio was prospectively studied in a selected urology clinic population of 420 patients. Total serum PSA ranged from 2.1 to 30 ng/ml; 154 had PC and 266 had BPH.
Receiver operating characteristic (ROC) curves were constructed for the total population (total-PSA range from 2.1 to 30 ng/ml) and for the diagnostic gray zone of 2.1-10 ng/ml. For the two groups, the free to total PSA ratio had a higher specificity than total-PSA for all sensitivity levels. Cut-off values were found to, vary with prostate weight.
Although free to total PSA ratio demonstrated better performances than total-PSA, its use in screening appears problematic, due to the low prevalence of prostate cancer.
血清前列腺特异性抗原（PSA）以不同分子形式存在，其各自的浓度被认为是提高鉴别良性前列腺增生（BPH）和前列腺癌（PC）的有用工具。
在一家选定的泌尿外科诊所的420例患者人群中，前瞻性地研究游离PSA与总PSA比值的相关性。血清总PSA范围为2.1至30 ng/ml；154例患有PC，266例患有BPH。
为总人群（总PSA范围为2.1至30 ng/ml）和2.1 - 10 ng/ml的诊断灰色区域构建了受试者操作特征（ROC）曲线。对于两组，在所有灵敏度水平下，游离PSA与总PSA比值的特异性均高于总PSA。发现临界值随前列腺重量而变化。
尽管游离PSA与总PSA比值的表现优于总PSA，但由于前列腺癌的患病率较低，其在筛查中的应用似乎存在问题。
