Aim: To evaluate the use of free/total prostate specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: The fPSA/tPSA ratio in the serum was analyzed in 187 men with tPSA...Aim: To evaluate the use of free/total prostate specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: The fPSA/tPSA ratio in the serum was analyzed in 187 men with tPSA ranging between 4.0 and 20.0 μg/L. All of them underwent ultrasound guided sextant prostatic biopsy. The results were calculated by SPSS 10.0 software. Results: (1) When the tPSA was within the ranges of 4.0 - 10.0 and 10.0 -20.0 μg/L, the prostate cancer detection rate was 18.1 % and 22.5 %, respectively; (2) The area under the curve (AUC) was bigger in fPSA/tPSA than in tPSA (P<0.05) in all the men; (3) When the cut off value of fPSA/tPSA ratio was set at 0.25 and the tPSA at 4.0 - 10.0 μg/L and 10.0 - 20.0 μg/L, the diagnostic sensitivity of tPSA was 90.5 % and 87.5 %, respectively. Thus at the tPSA ranges of 4.0 - 10.0 and 10.0 - 20.0 μg/L, 26.7 % and 11.3 % of biopsies could be avoided, respectively. Conclusion: The use of fPSA/tPSA ratio can improve the prostate cancer detection rate and reduce unnecessary biopsies when tPSA is within the range of 4.0 - 20.0 μg/L.展开更多
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Aim: To evaluate the use of free/total prostate specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: The fPSA/tPSA ratio in the serum was analyzed in 187 men with tPSA ranging between 4.0 and 20.0 μg/L. All of them underwent ultrasound guided sextant prostatic biopsy. The results were calculated by SPSS 10.0 software. Results: (1) When the tPSA was within the ranges of 4.0 - 10.0 and 10.0 -20.0 μg/L, the prostate cancer detection rate was 18.1 % and 22.5 %, respectively; (2) The area under the curve (AUC) was bigger in fPSA/tPSA than in tPSA (P<0.05) in all the men; (3) When the cut off value of fPSA/tPSA ratio was set at 0.25 and the tPSA at 4.0 - 10.0 μg/L and 10.0 - 20.0 μg/L, the diagnostic sensitivity of tPSA was 90.5 % and 87.5 %, respectively. Thus at the tPSA ranges of 4.0 - 10.0 and 10.0 - 20.0 μg/L, 26.7 % and 11.3 % of biopsies could be avoided, respectively. Conclusion: The use of fPSA/tPSA ratio can improve the prostate cancer detection rate and reduce unnecessary biopsies when tPSA is within the range of 4.0 - 20.0 μg/L.
