CAJ | 학술논문

目的：探讨总前列腺特异性抗原（T-PSA）、游离前列腺特异性抗原（F-PSA）及 F-PSA/T-PSA 比值在前列腺癌及前列腺增生的诊断和鉴别诊断中的应用价值。方法收集病理确诊为前列腺癌患者86例、前列腺增生患者487例和健康体检者188例的血液样本，采用电化学发光法检测检测血清中 T-PSA、F-PSA 浓度，计算F-PSA/T-PSA 比值，比较 T-PSA、F-PSA 和 F-PSA/T-PSA 比值在前列腺癌组、前列腺增生组及正常对照组之间的差异。结果与正常对照组相比，前列腺增生组和前列腺癌组的 T-PSA、F-PSA、F-PSA/T-PSA 的比值差异具有高度统计学意义（p<0.01）；与前列腺增生组相比，前列腺癌组的 T-PSA、F-PSA、F-PSA/T- PSA 的比值差异也具有高度统计学意义（p<0.01）。 T-PSA 在4.0~10.0 ng/mL 时，与前列腺增生组相比，前列腺癌组的 T-PSA 差异无显著性（p>0.05），F-PSA 差异有显著性（p<0.05），而 F-PSA/T- PSA 比值差异具有高度统计学意义（p<0.01）。结论T-PSA 可作为前列腺癌筛选的一个重要的指标，当 T-PSA 在4.0~10.0 ng/mL 时，F-PSA/T-PSA 用于筛选前列腺癌优于 T-PSA，选择0.15作为 F-PSA/T-PSA 的临界值对前列腺癌诊断有较高的灵敏度和特异度。
목적：탐토총전렬선특이성항원（T-PSA）、유리전렬선특이성항원（F-PSA）급 F-PSA/T-PSA 비치재전렬선암급전렬선증생적진단화감별진단중적응용개치。방법수집병리학진위전렬선암환자86례、전렬선증생환자487례화건강체검자188례적혈액양본，채용전화학발광법검측검측혈청중 T-PSA、F-PSA 농도，계산F-PSA/T-PSA 비치，비교 T-PSA、F-PSA 화 F-PSA/T-PSA 비치재전렬선암조、전렬선증생조급정상대조조지간적차이。결과여정상대조조상비，전렬선증생조화전렬선암조적 T-PSA、F-PSA、F-PSA/T-PSA 적비치차이구유고도통계학의의（p<0.01）；여전렬선증생조상비，전렬선암조적 T-PSA、F-PSA、F-PSA/T- PSA 적비치차이야구유고도통계학의의（p<0.01）。 T-PSA 재4.0~10.0 ng/mL 시，여전렬선증생조상비，전렬선암조적 T-PSA 차이무현저성（p>0.05），F-PSA 차이유현저성（p<0.05），이 F-PSA/T- PSA 비치차이구유고도통계학의의（p<0.01）。결론T-PSA 가작위전렬선암사선적일개중요적지표，당 T-PSA 재4.0~10.0 ng/mL 시，F-PSA/T-PSA 용우사선전렬선암우우 T-PSA，선택0.15작위 F-PSA/T-PSA 적림계치대전렬선암진단유교고적령민도화특이도。
Objective:To investigate the value of detection of prostate-specific antigen T-PSA, F-PSA and F-PSA/T-PSA in the diagnosis and differential diagnosis of prostate cancer and prostatic hyperplasia. Methods:The blood samples of 86 prostate cancer patients, 487 prostatic hyperplasia patients and 188 healthy persons from Foshan First People's Hospital were collected. The serum concentration of total prostate-specific antigen (T-PSA) and free prostate specific antigen (F-PSA)were examined by electrochemical luminescence. The F-PSA/T-PSA ratio was calculated. The significant difference of T-PSA, F-PSA and F-PSA/T-PSA ratio among the prostate cancer group, prostatic hyperplasia group and control group were calculated statistically and respectively. Results:The T-PSA, F-PSA, F-PSA/T-PSA ratio in the prostatic hyperplasia group and prostate cancer group was significantly different from those of the control group (p<0.01). The T-PSA, F-PSA, F-PSA/T-PSA ratio in the prostate cancer group was significantly different from those of the prostatic hyperplasia group (p<0.01). When the concentration of T-PSA ranged from 4.0 ng/ml to 10.0 ng/ml, there was no significant difference in the T-PSA between the prostate cancer group and the prostatic hyperplasia group, while the F-PSA and F-PSA/T-PSA ratio were significantly different between the two groups, When the concentration of T-PSA ranged from 4.0 ng/ml to 10.0 ng/ml, the F-PSA/T-PSA threshold take 0.1, 0.15, 0.16, 0.17, 0.2, respectively, the sensitivity was 33.3%, 61.9%, 61.9%, 69.0%, 76.2 %, respectively; the specificity was 89.1% , 70.1% , 64.7% , 60.0% , 44.6% , respectively. The critical value (0.15)was the best screening indicator. Conclusions:T-PSA can be used as an important screening indicator of prostate cancer. When concentration of T-PSA ranged from 4.0 to 10.0ng/ml, the F-PSA/T-PSA ratio was a better choice for prostate cancer screening than T-PSA, in which a higher sensitivity and specificity were achieved when the F-PSA/T-PSA threshold was 0.15.