Objective To evaluate using prostate specific antigen (PSA) and percent free PSA(fPSA) for the diagnosis of prostate cancer(Pca) and benign prostate hyperplasia(BPH). Methods 315 men with BPH and 55 men with Pca wer...Objective To evaluate using prostate specific antigen (PSA) and percent free PSA(fPSA) for the diagnosis of prostate cancer(Pca) and benign prostate hyperplasia(BPH). Methods 315 men with BPH and 55 men with Pca were randomly chosen, serum fPSA and total PSA were determined by ELISA and then we compared the sensitivity and specificity of PSA and percent fPSA for the diagnosis of Pca. Results While using PSA and percent fPSA for the diagnosis of prostate cancer, the sensitivity was similar (89.8% vs. 94.5%, P> 0.05), but the specificity was significanty different (52.7% vs. 89.8%, P< 0.005). Conclusions Using percent fPSA might decrease false-positive and avoid 37.1% negative biopsies as compared with PSA, it is very valuable for the diagnosis of Pca.展开更多
Objective:To test the diagnostic performance of percent free prostate-specific antigen(%fPSA)in predicting any prostate cancer(PCa)and high-grade prostate cancer(HGPCa)in a retrospective multi-center biopsy cohort wit...Objective:To test the diagnostic performance of percent free prostate-specific antigen(%fPSA)in predicting any prostate cancer(PCa)and high-grade prostate cancer(HGPCa)in a retrospective multi-center biopsy cohort with a PSA level of 4.0e10.0 ng/mL in China.Methods:Consecutive patients with a PSA of 4.0-10.0 ng/mL who underwent transrectal ultrasound-guided biopsy were enrolled at 16 Chinese medical centers from January 1st,2010 to December 31st,2013.Total and free serum PSA determinations were performed using three types of electro-chemiluminescence immunoassays recalibrated to the World Health Organization(WHO)standard.The diagnostic accuracy of PSA,%fPSA,and %fPSA in combination with PSA(%fPSA t PSA)was determined using the area under the receiver operating characteristic(ROC)curve(AUC).Results:A total of 2310 consecutive men with PSA levels between 4.0 and 10.0 ng/mL were included,and the detection rate of PCa was 25.1%.The AUC of%fPSA and %fPSA t PSA in predicting any PCa was superior to PSA alone in men aged≥60 years(0.623 vs.0.534,p<0.0001)but not in men aged 40e59 years(0.517 vs.0.518,p=0.939).Similar result was yield in predicting HGPCa.Conclusion:In a clinical setting of Chinese men with 4.0e10.0 ng/mL PSA undergoing initial prostate biopsy,adding %fPSA to PSA can moderately improve the diagnostic accuracy for any PCa and HGPCa compared with PSA alone in patients≥60 but not in patients aged 40-59 years.展开更多
Prostate-specific antigen (PSA) testing for the early diagnosis of prostate cancer has led to a decrease in cancer mortality. However, the high prevalence of low-grade prostate cancer and its long natural history, c...Prostate-specific antigen (PSA) testing for the early diagnosis of prostate cancer has led to a decrease in cancer mortality. However, the high prevalence of low-grade prostate cancer and its long natural history, competing causes of death in older men and treatment patterns of prostate cancer, have led to dramatic overtreatment of the disease. Improved markers of prostate cancer lethality are needed to reduce the overtreatment of prostate cancer that leads to a reduced quality of life without extending life for a high proportion of men. The PSA level prior to treatment is routinely used in multivariable models to predict prostate cancer aggressiveness. PSA isoforms and PSA kinetics have been associated with more aggressive phenotypes, but are not routinely employed as part of prediction tools prior to treatment. PSA kinetics is a valuable marker of lethality post treatment and routinely used in determininE the need for salva=e theraov.展开更多
目的建立产生抗人游离前列腺特异抗原单克隆抗体(f-PSA m Ab)的细胞株,获得抗体后建立抗人f-PSA化学发光免疫分析法(CLIA)并进行应用。方法采用杂交瘤技术获得2株稳定分泌抗f-PSA m Ab的细胞株,将细胞株用转瓶扩大培养并将上清液采用亲...目的建立产生抗人游离前列腺特异抗原单克隆抗体(f-PSA m Ab)的细胞株,获得抗体后建立抗人f-PSA化学发光免疫分析法(CLIA)并进行应用。方法采用杂交瘤技术获得2株稳定分泌抗f-PSA m Ab的细胞株,将细胞株用转瓶扩大培养并将上清液采用亲和纯化法获得抗体,ELISA测定抗体效价、特异性及表位,表面等离子共振法测抗体亲和力;建立双抗体夹心CLIA,采用标准曲线定量法对该体系进行分析性能评估,同时对426例临床血清样本进行检测[其中130例的总PSA水平在(4~10) ng/mL,为"诊断灰区"],评价该试剂与罗氏试剂的检测一致性。结果获得抗人f-PSA m Ab的杂交瘤细胞株(f-10-1、f-14-1)。用f-10-1和f-14-1建立的CLIA的检测范围为(0. 1~30) ng/mL,灵敏度为0. 05 ng/mL,检测结果的相对偏差均在±5%内,与癌胚抗原(CEA)、甲胎蛋白(AFP)及结合态PSA(c-PSA)无交叉反应,该试剂与罗氏试剂相关系数达到0. 99,灰区样本阳性符合率、阴性符合率、总符合率均高于90%。结论成功制备了抗人f-PSA m Ab,建立了特异性定量检测人f-PSA的双抗体夹心CLIA。展开更多
文摘Objective To evaluate using prostate specific antigen (PSA) and percent free PSA(fPSA) for the diagnosis of prostate cancer(Pca) and benign prostate hyperplasia(BPH). Methods 315 men with BPH and 55 men with Pca were randomly chosen, serum fPSA and total PSA were determined by ELISA and then we compared the sensitivity and specificity of PSA and percent fPSA for the diagnosis of Pca. Results While using PSA and percent fPSA for the diagnosis of prostate cancer, the sensitivity was similar (89.8% vs. 94.5%, P> 0.05), but the specificity was significanty different (52.7% vs. 89.8%, P< 0.005). Conclusions Using percent fPSA might decrease false-positive and avoid 37.1% negative biopsies as compared with PSA, it is very valuable for the diagnosis of Pca.
文摘Objective:To test the diagnostic performance of percent free prostate-specific antigen(%fPSA)in predicting any prostate cancer(PCa)and high-grade prostate cancer(HGPCa)in a retrospective multi-center biopsy cohort with a PSA level of 4.0e10.0 ng/mL in China.Methods:Consecutive patients with a PSA of 4.0-10.0 ng/mL who underwent transrectal ultrasound-guided biopsy were enrolled at 16 Chinese medical centers from January 1st,2010 to December 31st,2013.Total and free serum PSA determinations were performed using three types of electro-chemiluminescence immunoassays recalibrated to the World Health Organization(WHO)standard.The diagnostic accuracy of PSA,%fPSA,and %fPSA in combination with PSA(%fPSA t PSA)was determined using the area under the receiver operating characteristic(ROC)curve(AUC).Results:A total of 2310 consecutive men with PSA levels between 4.0 and 10.0 ng/mL were included,and the detection rate of PCa was 25.1%.The AUC of%fPSA and %fPSA t PSA in predicting any PCa was superior to PSA alone in men aged≥60 years(0.623 vs.0.534,p<0.0001)but not in men aged 40e59 years(0.517 vs.0.518,p=0.939).Similar result was yield in predicting HGPCa.Conclusion:In a clinical setting of Chinese men with 4.0e10.0 ng/mL PSA undergoing initial prostate biopsy,adding %fPSA to PSA can moderately improve the diagnostic accuracy for any PCa and HGPCa compared with PSA alone in patients≥60 but not in patients aged 40-59 years.
文摘目的:探讨u PCA3m RNA、t PSA、f PSA/t PSA、PSAD对PSA灰区前列腺癌的诊断价值。方法:经前列腺穿刺活检诊断为前列腺增生(BPH)111例和前列腺癌(PCa)89例,测定血清t PSA、f PSA与前列腺体积,所有病例均计算f PSA/t PSA、PSAD。用RT-PCR的方法检测PSA m RNA、PCA3 m RNA的含量,以PCA3 m RNA/PSA m RNA表示PCA3 m RNA的含量。比较两组间t PSA、f PSA/t PSA、PSAD及PCA3m RNA各指标的差异,分析各指标在ROC曲线下的面积、各指标的诊断敏感性和特异性。结果:PCa组的f PSA/t PSA较BPH组降低(P<0.01),PCa组的t PSA、PSAD及PCA3 m RNA较BPH组均升高(P<0.01)。t PSA、f PSA/t PSA、PSAD及PCA3 m RNA在ROC曲线下的面积从大到小依次是PCA3 m RNA>PSAD>f PSA/t PSA>t PSA。当PCA3 m RNA和PSAD临界值分别为0.27和0.15时,诊断PCa的敏感性和特异性分别是86.5%和77.5%,80.9%和55.9%。结论:u PCA3m RNA、f PSA/t PSA、PSAD的测定能显著提高灰区PCa诊断的敏感性和特异性,且u PCA3 m RNA诊断效能最高。
文摘Prostate-specific antigen (PSA) testing for the early diagnosis of prostate cancer has led to a decrease in cancer mortality. However, the high prevalence of low-grade prostate cancer and its long natural history, competing causes of death in older men and treatment patterns of prostate cancer, have led to dramatic overtreatment of the disease. Improved markers of prostate cancer lethality are needed to reduce the overtreatment of prostate cancer that leads to a reduced quality of life without extending life for a high proportion of men. The PSA level prior to treatment is routinely used in multivariable models to predict prostate cancer aggressiveness. PSA isoforms and PSA kinetics have been associated with more aggressive phenotypes, but are not routinely employed as part of prediction tools prior to treatment. PSA kinetics is a valuable marker of lethality post treatment and routinely used in determininE the need for salva=e theraov.
文摘目的建立产生抗人游离前列腺特异抗原单克隆抗体(f-PSA m Ab)的细胞株,获得抗体后建立抗人f-PSA化学发光免疫分析法(CLIA)并进行应用。方法采用杂交瘤技术获得2株稳定分泌抗f-PSA m Ab的细胞株,将细胞株用转瓶扩大培养并将上清液采用亲和纯化法获得抗体,ELISA测定抗体效价、特异性及表位,表面等离子共振法测抗体亲和力;建立双抗体夹心CLIA,采用标准曲线定量法对该体系进行分析性能评估,同时对426例临床血清样本进行检测[其中130例的总PSA水平在(4~10) ng/mL,为"诊断灰区"],评价该试剂与罗氏试剂的检测一致性。结果获得抗人f-PSA m Ab的杂交瘤细胞株(f-10-1、f-14-1)。用f-10-1和f-14-1建立的CLIA的检测范围为(0. 1~30) ng/mL,灵敏度为0. 05 ng/mL,检测结果的相对偏差均在±5%内,与癌胚抗原(CEA)、甲胎蛋白(AFP)及结合态PSA(c-PSA)无交叉反应,该试剂与罗氏试剂相关系数达到0. 99,灰区样本阳性符合率、阴性符合率、总符合率均高于90%。结论成功制备了抗人f-PSA m Ab,建立了特异性定量检测人f-PSA的双抗体夹心CLIA。