Ornstein D K, Smith D S, Humphrey P A, Catalona W J
Department of Pathology, Washington University School of Medicine, St. Louis, Missouri, USA.
J Urol. 1998 Apr;159(4):1234-7.
We determine the influence of age, prostate volume, total serum prostate specific antigen (PSA) level and histological evidence of acute inflammation in biopsy specimens on the percent free serum PSA level in men without clinically detectable prostate cancer.
We studied 70 men with total PSA levels of 2.6 to 9.9 ng./ml. who had undergone at least 3 sets of prostate biopsies that were negative for cancer as part of our PSA based prostate cancer screening program. Total and free PSA levels were measured using Hybritech immunoassays. Prostate volume and the presence of acute inflammation were determined from the most recent transrectal ultrasonography and prostate needle biopsy.
Percent free PSA levels correlated significantly with age (r = 0.48, p = 0.0001) and prostate volume (r = 0.44, p = 0.0002) but not with total PSA (r = 0.04, p = 0.7). The mean percent free PSA did not differ for those with or without acute inflammation. Multivariate regression models demonstrated that age and prostate volume were significant predictors of percent free PSA.
Among men without detectable prostate cancer and a total PSA level between 2.6 and 9.9 ng./ml. percent free serum PSA was higher in older men and in men with a larger prostate gland but was not influenced by total PSA level or the presence of acute inflammation in the prostatic biopsy specimen.
我们确定年龄、前列腺体积、血清总前列腺特异性抗原（PSA）水平以及活检标本中急性炎症的组织学证据对无临床可检测前列腺癌男性的游离血清PSA水平百分比的影响。
我们研究了70名总PSA水平为2.6至9.9 ng./ml的男性，作为我们基于PSA的前列腺癌筛查项目的一部分，他们至少接受了3组前列腺活检，结果均为癌症阴性。使用Hybritech免疫测定法测量总PSA和游离PSA水平。通过最近的经直肠超声检查和前列腺穿刺活检确定前列腺体积和急性炎症的存在情况。
游离PSA水平百分比与年龄（r = 0.48，p = 0.0001）和前列腺体积（r = 0.44，p = 0.0002）显著相关，但与总PSA无关（r = 0.04，p = 0.7）。有或无急性炎症者的平均游离PSA百分比无差异。多变量回归模型表明，年龄和前列腺体积是游离PSA水平百分比的重要预测因素。
在无可检测前列腺癌且总PSA水平在2.6至9.9 ng./ml之间的男性中，老年男性和前列腺较大的男性的游离血清PSA百分比更高，但不受总PSA水平或前列腺活检标本中急性炎症的影响。
