van Iersel M P, Witjes W P, Thomas C M, Segers M F, Oosterhof G O, Debruyne F M
Department of Urology, University Hospital, Nijmegen, St. Radboud, The Netherlands.
Prostate Suppl. 1996;7:48-57.
The total prostate-specific antigen (t-PSA) in serum measured by PSA assays represents the sum of free (f-PSA) and PSA complexed with alpha 1-antichymotrypsin. The f-PSA/t-PSA (F/T) ratio in prostate cancer (PCA) patients is lower than in patients suffering from benign prostatic hyperplasia (BPH). This review summarizes the current literature on the clinical relevance of measurement of the F/T PSA ratio.
Discussed are: physiology of PSA, assays for t-PSA and F/T ratio, factors which bias the F/T PSA ratio, use of F/T PSA ratio in the detection of PCA, correlation with histological features, and pathological stage.
Using the F/T ratio in the intermediate t-PSA range, a reduction of approximately 30% in biopsies can be accomplished in the detection of prostate cancer.
The F/T PSA ratio could become a valuable tool in the differentiation of BPH from PCA. To accomplish this goal, an international standardization not only for the t-PSA measurement but also for the F/T PSA ratio must be a priority for manufacturers of PSA assays.
通过前列腺特异性抗原（PSA）检测法测得的血清总前列腺特异性抗原（t-PSA）代表游离前列腺特异性抗原（f-PSA）与与α1-抗糜蛋白酶结合的PSA的总和。前列腺癌（PCA）患者的f-PSA/t-PSA（F/T）比值低于良性前列腺增生（BPH）患者。本综述总结了目前关于F/T PSA比值测定临床相关性的文献。
讨论内容包括：PSA的生理学、t-PSA和F/T比值的检测方法、影响F/T PSA比值的因素、F/T PSA比值在PCA检测中的应用、与组织学特征的相关性以及病理分期。
在t-PSA处于中等水平时使用F/T比值，在前列腺癌检测中可减少约30%的活检。
F/T PSA比值可能成为区分BPH与PCA的有价值工具。为实现这一目标，PSA检测试剂制造商的首要任务不仅是对t-PSA测量进行国际标准化，还要对F/T PSA比值进行国际标准化。
