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目的探讨利用血清游离前列腺特异性抗原(fPSA)和总前列腺特异性抗原(tPSA)的比值(f/tPSA),提高tPSA2.6～4.0ng/ml前列腺癌的诊断率的价值。方法对117例tPSA在2.6～4ng/ml可疑前列腺癌患者行直肠B超引导下前列腺穿刺活检,对患者血清tPSA,fPSA及f/t PSA值及其他临床病理资料进行统计学分析。结果经病理诊断良性前列腺增生(BPH)82例和前列腺癌35例,35例癌中Gleason score≤4分共6例(17%),Gleason score5-7分和8-10分别为22例(63%)和7例(20%)。前列腺癌的f/tPSA明显高于BPH(P＜0.01),以f/tPSA0.22为界值,诊断癌的特异性为83%,敏感性为71%,阳性预测值为68%。结论f/t PSA作为一项辅助检查可提高tPSA 2.6～4.0ng/ml前列腺癌的诊断率。
Objective To explore the value of increasing the diagnostic value of tPSA2.6 ~ 4.0ng / ml prostate cancer using the ratio of serum free PSA to total PSA t f (f / tPSA). Methods A total of 117 patients with suspected prostate cancer with tPSA ranging from 2.6 to 4 ng / ml underwent transrectal B-guided prostate biopsy. The serum levels of tPSA, fPSA, f / t PSA and other clinicopathological data were analyzed statistically. Results Eighty-two BPH cases and 35 prostate cancer cases were diagnosed by pathology. Six cases (17%) had Gleason score≤4 in 35 cases, 22 cases (63 cases) had Gleason score 5-7 points and 8-10 cases %) And 7 cases (20%). The f / tPSA of prostate cancer was significantly higher than that of BPH (P <0.01). The specificity of f / tPSA0.22 for diagnosis of cancer was 83%, the sensitivity was 71% and the positive predictive value was 68%. Conclusions f / t PSA as a supplementary test can improve the diagnostic rate of tPSA 2.6 ~ 4.0ng / ml prostate cancer.