CAJ | 학술논문

目的:研究全血锌浓度与前列腺癌的关系,并将其与血清前列腺特异性抗原(PSA)联合,探讨在前列腺癌诊断中的应用价值.方法:收集自2005年7月至2008年10月东南大学附属中大医院和南京大学医学院附属鼓楼医院收治的前列腺癌患者95例,前列腺增生症患者91例,采用火焰吸收原子分光光度法测定全血锌浓度,采用放射免疫法测定血清PSA值.结果:全血锌浓度前列腺癌组(4.73±1.51)μg/mL,前列腺增生症组(6.82±1.63)μg/mL,两组间有显著差异(P＜0.001).两组血清PSA值总体分布有显著差异(P＜0.01),但在4.0～10.0ng/mL区间,两组例数比例无显著差异(P=0.143).以前列腺增生症组为对照,全血锌浓度诊断前列腺癌的ROC曲线下面积为0.82;在血清PSA4.0～10.0ng/mL区间范围,此曲线下面积为0.79.在血清PSA4.0～10.0ng/mL区间范围,全血锌浓度取5.24μg/mL界值时有最佳的诊断准确性,Youden指数0.46;其与血清PSA取界值4.0ng/mL串联应用,诊断的特异度为75%,是血清PSA单独诊断时的2.34倍,Youden指数为0.51,是血清PSA单独诊断的2.22倍,并联无助于诊断,Youden指数仅0.14.结论:全血锌浓度检测有助于前列腺癌与前列腺增生症的鉴别诊断,其与血清PSA联合应用(串联),能够显著改善血清PSA 4.0～10.0ng/mL区间内的诊断阳性率,可为前列腺癌的诊断提供有价值的参考,有一定的临床应用前景.
목적:연구전혈자농도여전렬선암적관계,병장기여혈청전렬선특이성항원(PSA)연합,탐토재전렬선암진단중적응용개치.방법:수집자2005년7월지2008년10월동남대학부속중대의원화남경대학의학원부속고루의원수치적전렬선암환자95례,전렬선증생증환자91례,채용화염흡수원자분광광도법측정전혈자농도,채용방사면역법측정혈청PSA치.결과:전혈자농도전렬선암조(4.73±1.51)μg/mL,전렬선증생증조(6.82±1.63)μg/mL,량조간유현저차이(P＜0.001).량조혈청PSA치총체분포유현저차이(P＜0.01),단재4.0～10.0ng/mL구간,량조례수비례무현저차이(P=0.143).이전렬선증생증조위대조,전혈자농도진단전렬선암적ROC곡선하면적위0.82;재혈청PSA4.0～10.0ng/mL구간범위,차곡선하면적위0.79.재혈청PSA4.0～10.0ng/mL구간범위,전혈자농도취5.24μg/mL계치시유최가적진단준학성,Youden지수0.46;기여혈청PSA취계치4.0ng/mL천련응용,진단적특이도위75%,시혈청PSA단독진단시적2.34배,Youden지수위0.51,시혈청PSA단독진단적2.22배,병련무조우진단,Youden지수부0.14.결론:전혈자농도검측유조우전렬선암여전렬선증생증적감별진단,기여혈청PSA연합응용(천련),능구현저개선혈청PSA 4.0～10.0ng/mL구간내적진단양성솔,가위전렬선암적진단제공유개치적삼고,유일정적림상응용전경.
Objective: To study the relationship between the whole blood zinc concentration and prostate carcinoma and to explore the diagnostic value of the whole blood zinc concentration combined with blood serum prostate specific antigen (PSA) for prostate cancer. Methods: A total of 95 patients with prostate carcinoma and 91 patients with benign prostate hyperplasia were selected between July 2005 and October 2008 in Zhongda Hospital of Southeast University and The Affiliated Drum Tower Hospital of Nanjing University Medical School. The whole blood zinc concentration was analyzed by atomic absorption spectometry. The serum PSA was analyzed by radioimmunoassay. Results: The volumes of the whole blood zinc concentration were 4.73±1.51 μg/mL in the prostate carcinoma group and 6.82±1.63 μg/mL in the benign prostate hyperplasia group, with a significant difference between the two groups (P＜0.001). The serum PSA general distribution was significantly different between the two groups (P＜0.01). There was no significant difference in the serum PSA of 4.0 to 10.0 ng/mL between the two groups (P=0.14). Compared with that in the benign prostate hyperplasia group, the area under ROC curve for the whole blood zinc concentration in the prostate carcinoma group was 0.82. The diagnostic accuracy was optimal with 5.24μg/mL set as the cut-off value of the whole blood zinc concentration and the Youden's index was 0.46 when it was combined with serum PSA 4.0 ng/mL (connection in series). The specificity was 75%, up to 2.34 times of serum PSA applied alone. Meanwhile, the Youden's index was 0.51, achieving 2.22 times. It was not helpful for the diagnosis of prostate carcinoma that the two diagnostic tools were in parallel by which the Youden's index was only 0.14. Conclusion: Detection of the whole blood zinc concentration is beneficial for differentiation of prostate carcinoma from benign prostate hyperplasia. Combined with serum PSA (connection in series), it can significantly impove diagnostic efficiency when PSA was 4.0～10.0ng/mL. Detection of the whole blood zinc concentration can provide valuable information for the diagnosis of prostate cancer and worths clincal application.