中国医科大学学报

中国医科大学学报

中国医科大学学报

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前列腺特异性抗原对前列腺癌诊断价值的探讨

王炜,李传刚,刘辉,杨玻   

  1. 大连医科大学附属第二医院泌尿外科,辽宁大连116023
  • 收稿日期:2015-04-26 出版日期:2016-01-05 发布日期:2015-12-30
  • 通讯作者: 杨玻,E-mail:yangbo1501@163.com
  • 作者简介:王炜(1980 -),男,主治医师,硕士研究生.

Evaluation of the Diagnostic Value of PSA in Prostate Cancer Patients

WANG Wei,LI Chuan-gang,LIU Hui,YANG Bo   

  1. Department of UrinarySurgery,The Second Affiliated Hospital,Dalian Medical University,Dalian116023,China
  • Received:2015-04-26 Online:2016-01-05 Published:2015-12-30

摘要:

目的 探讨血清前列腺特异性抗原(PSA)、游离PSA/PSAF/T)比值及前列腺特异性抗原密度(PSAD)在确定前列腺癌诊断中的价值。方法 选取20137月至20148月经穿刺活检和(或)手术标本病理确诊的前列腺疾病患者208例,分为前列腺癌组(恶性组)和前列腺增生组(良性组);根据经直肠超声(TRUS结果 分为有结节(阳性)组和无结节(阴性)组;根据结节回声特性分为低回声组和高(混合)回声组;检测血清总PSA、游离PSA、计算F/T比值,TRUS测量前列腺体积并计算PSAD值,PSA分别取4102030 ng/mL为界值,F/T0.160.180.20,根据PSAng/mL)水平分为5组,PSA<44PSA<1010PSA<2020PSA<30PSA30组为界值,PSAD0.150.250.35 ng/mL·cm3)为界值,比较各指标在不同界值时预测前列腺癌的敏感度、特异度和正确指数,探讨确诊前列腺癌的最佳PSAF/T值和PSAD值。结果前列腺癌组患者的PSA值、PSAD值及低回声结节出现的比例高于前列腺增生组,差异有统计学意义(P < 0.01);PSA分别取4102030 ng/mL为界值时预测前列腺癌的敏感度为94.03%84.33%67.16%56.72 %,特异度为31.08%78.38%93.24%97.30%,正确指数为0.257 10.627 10.604 00.540 2F/T0.160.180.20为界值时预测前列腺癌的敏感度为71.64%73.88%76.87 %,特异度为67.57%64.86%58.11 %,正确指数为0.392 10.387 4 0.349 8PSAD 0.150.250.35 ng/mL·cm3)为界值时预测前列腺癌的敏感度为88.81%80.60%73.88%,特异度为68.92%87.84%95.95%,正确指数0.573 30.684 40.698 3 结论 PSA10 ng/mLF/T0.16PSAD0.35 ng/mL·cm3)时诊断前列腺癌的敏感度、特异度及正确指数均较高。

关键词: 前列腺癌, 前列腺特异性抗原

Abstract:

Objective To compare the performance of prostate specific antigenPSA),Free/Total PSAF/T),and the PSA densityPSADin prostate cancer screen. Methods A total of 208 cases of patients with prostate disease who did needle biopsy andorpathology confirmation of surgery specimen from July 2013 to August 2014 were recruited in the studyand divided into prostate cancer groupmalignant groupand prostate hyperplasia groupbenign group. According to the results of transrectal ultrasoundTRUS),the patients were divided into nodulespositivegroup and non nodulesnegativegroup. According to the nodule echo characteristicsthe patients were divided into low echo group and high echomixedgroup. Total PSA and free PSA in serum were detected to calculate the F/T ratio. The prostate volume was measured by TRUSand PASD values were calculated. Taking 4102030 ng/mL as dividing values for PSAtaking 0.160.18 and 0.20 as dividing values for F/T. According to the level of PSAng/mL),they were divided into 5 groupswith PSA < 44PSA< 1010PSA<2020PSA<30PSA30 as dividing values. Taking 0.150.25 and 0.35 ng/ mL·cm3as dividing values for PSADthe sensitivityspecific degree and correct index of the prostate in the different dividing values were comparedand the best PSAF/T and PSAD values for prostate cancer diagnosis were explored. Results PSAPSAD values and the percentage of low echo nodules appear of the prostate cancer group are significantly higher than that of the prostate hyperplasia groupP < 0.01. Taking 4102030 ng/mL as the dividing values of PSAthe sensitivity of the prostate cancer was 94.03%84.33%67.16% and 56.72 %with the specific degree of 31.08%78.38%93.24% and 97.30%the correct index of 0.257 10.627 10.604 0 and 0.540 2. Taking 0.160.180.20 as dividing values of F/Tthe sensitivity of the prostate cancer was 71.64%73.88% and 76.87%with specific degree of 67.57%64.86%and58.11%andcorrectindexof0.39210.3874and0.3498.Taking0.150.250.35ng/ mL·cm3as dividing values of PSADthe sensitivity of the prostate cancer was 88.81%80.60% and 73.88%with specific degree of 68.92%87.84% and 95.95%and correct index of 0.573 30.684 4 and 0.698 3. Conclusion When PSA takes 10 ng/mLF/T takes 0.16PSAD takes 0.35 ng/ mL·cm3),the sensitivity of the prostate cancerspecific degree and correct index are relatively high in diagnosis of prostate cancer.

Key words: prostate cancer, prostate specific antigen

中图分类号: 

  • R736.6
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