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目的:进一步了解前列腺特异性抗原(PSA)、游离前列腺特异性抗原(FPSA)与总前列腺特异性抗原(TPSA)比值(FPSA/TPSA)的测定在诊断前列腺癌的临床价值。方法:采用化学发光免疫分析法(CLIA)对前列腺癌患者57例,前列腺增生患者147例血清PSA、FPSA和FPSA/TPSA在各组中的改变情况及取不同界值时对前列腺癌的诊断意义。结果:在诊断灰区外高值区,TPSA、F/T在两组间的差别均有显著性意义(P<0.05,P<0.05);在诊断灰区患者间TPSA差别无显著性意义(P>0.05),而F/T值的差别有显著性意义(P<0.05);在灰区外低值区TPSA、F/T值在两组间差别无显著性意义(P>0.05)。如果以血清PSA值4 ng/ml为阈值,诊断前列腺癌的灵敏度为100%,特异性为52.6%,如果以血清PSA 4 ng/ml为阈值,同时结合FPSA/TPSA并以16为阈值,诊断前列腺癌的灵敏度为100%,而特异性为87.5%。结论:PSA与FPSA联合检测可以提高对前列腺癌诊断的特异性。
Objective: To further understand the clinical value of prostate specific antigen (PSA), free prostate specific antigen (FPSA) and total prostate specific antigen (TPSA) ratio (FPSA / TPSA) in the diagnosis of prostate cancer. Methods: The changes of serum PSA, FPSA and FPSA / TPSA in 57 patients with prostate cancer and 147 patients with benign prostatic hyperplasia by chemiluminescence immunoassay (CLIA) and the diagnostic value of different levels of serum PSA for prostate cancer . Results: The difference of TPSA and F / T between the two groups was significant (P <0.05, P <0.05) in the high value area outside the gray area, there was no significant difference between the two groups (P <0.05), while the difference of F / T value was significant (P <0.05). There was no significant difference in the TPSA and F / T values between the two groups in the low value area outside the gray area (P> 0.05). If the serum PSA value of 4 ng / ml threshold for the diagnosis of prostate cancer with a sensitivity of 100%, specificity of 52.6%, if the serum PSA 4 ng / ml as the threshold, combined with FPSA / TPSA and 16 as the threshold diagnosis Prostate cancer has a sensitivity of 100% and a specificity of 87.5%. Conclusion: Combined detection of PSA and FPSA can improve the diagnosis of prostate cancer.