CAJ | 학술논문

目的探讨经直肠三维超声与血清前列腺特异性抗原(PSA)相关参数前列腺特异抗原密度(PSAD)、前列腺移行区抗原密度(PSAT)、游离前列腺特异抗原百分比和前列腺特异抗原密度的比值[(F/T)/PSAD]诊断前列腺癌的价值.方法血清PSA位于4～20μg/L之间的患者78例,应用经直肠三维超声检测前列腺体积和移行区体积,分别计算出PSA相关参数PSAD、PSAT、(F/T)/PSAD.经直肠超声引导下前列腺穿刺活检,获得病理诊断.结果前列腺癌组27例,前列腺增生组51例,PSAD、PSAT、(F/T)/PSAD在前列腺癌和前列腺增生组中的差异有统计学意义(P<0.05),诊断前列腺癌的ROC曲线下面积分别为 0.736、0.760、0.800.各参数诊断前列腺癌的合理截点分别为:PSAD>0.20、PSAT>0.33、(F/T)/PSAD<0.8.结论血清PSA在4～20μg/L时,PSAD、PSAT、(F/T)/PSAD对前列腺癌和前列腺增生的鉴别有重要参考价值.通过经直肠三维超声计算前列腺体积得出的参数更可靠.
목적 탐토경직장삼유초성여혈청전렬선특이성항원(PSA)상관삼수전렬선특이항원밀도(PSAD)、전렬선이행구항원밀도(PSAT)、유리전렬선특이항원백분비화전렬선특이항원밀도적비치[(F/T)/PSAD]진단전렬선암적개치.방법 혈청PSA위우4～20μg/L지간적환자78례,응용경직장삼유초성검측전렬선체적화이행구체적,분별계산출PSA상관삼수PSAD、PSAT、(F/T)/PSAD.경직장초성인도하전렬선천자활검,획득병리진단.결과 전렬선암조27례,전렬선증생조51례,PSAD、PSAT、(F/T)/PSAD재전렬선암화전렬선증생조중적차이유통계학의의(P<0.05),진단전렬선암적ROC곡선하면적분별위 0.736、0.760、0.800.각삼수진단전렬선암적합리절점분별위:PSAD>0.20、PSAT>0.33、(F/T)/PSAD<0.8.결론 혈청PSA재4～20μg/L시,PSAD、PSAT、(F/T)/PSAD대전렬선암화전렬선증생적감별유중요삼고개치.통과경직장삼유초성계산전렬선체적득출적삼수경가고.
Objective To investigate the utility of serum prostate specific antigen(PSA) density (PSAD),prostate antigen transition zone density(PSAT) and the ratio of free/total PSA with PSAD [(F/T)/PSAD] in the diagnosis of prostatic carcinoma (PCa) by three-dimensional ultrasonography.Methods Seventy-eight patients (serum prostate-specific antigen between 4-20 μg/L ) were involved.The prostatic volume and its transition zone volume were measured by three-dimensional ultrasonography.Then the relative parameters of PSA [PSAD,PSAT and (F/T)/PSAD] were calculated.Pathologic types were determined by using needle biopsy of prostate.Results Among them,27 patients were suffering from PCa,while the other 51 benign prostate hypertrophy (BPH).The difference of PSAD,PSAT and (F/T)/PSAD between PCa and BPH had arrived statistical significance (P<0.05).Proportions under the PCa curves were 0.736,0.760,0.800 respectively.Considering both sensitivity and specificity,a cutoff was recommanded:PSAD>0.20,PSAT>0.33,(F/T)/PSAD<0.8.Conclusions When the serum PSA level is between 4 μg/L and 20 μg/L,PSAD,PSAT and (F/T)/PSAD are of significant value to differentiate PCa from benign prostatic hyperplasia patients.The data are more reliable if prostatic volume are calculated by three-dimensional transrectal ultrasonography.