目的 研究复合前列腺特异性抗原(c-PSA)、总前列腺特异性抗原(t-PSA)在鉴别诊断前列腺癌和良性前列腺增生时的应用价值.方法 选择两组实验对象,Pca组89例经B超、病理确诊的前列腺癌(Pca)者.BPH组为111例良性前列腺增生患者.采用化学发光法检测其c-PSA、t-PSA,记录结果并进行统计分析.结果 Pca和BPH组的c-PSA、t-PSA和年龄值,BPH和Pca组t-PSA含量(3.6±2.4)ng/ml、(15.2±16.2)ng/ml,差异有极显著性(P<0.01),年龄值两组间,差异无显著性(P>0.05).t-PSA的cutoff为10 ng/ml时,Pca89例中45例为假阴性(50.6%),t-PSA的cutoff为2.5 ng/ml时,Pca 89例中24例为假阴性(27.0%),但假阳性率相应升高.BPH和Pca的c-PSA含最(0.08±0.06)ng/ml、(28.9±37.6)ng/ml(P<0.01),c-PSA的cutoff为2.5 ng/ml时,Pca89例中18例为假阴性(20.2%).t-PSA的cutoff为10ng/ml时,与c-PSA同时阳性占46.1%,而将t-PSA的cutoff定为2.5 ng/ml时,与c-PSA同时阳性占69.7%.结论 c-PSA在t-PSA<10ng/mL的特异性优于t-PSA,t-PSA的cutoff为10 ng/ml的设置过高,建议将其调整为2.5ng/ml,结合c-PSA(cutoff:2.5 ng/ml)将有效提高Pca诊断的特异性和灵敏度.%Objective To research the using value of t-PSA and c-PSA to differential diagnosis the prostate neoplasms and BPH. Methods The level of t-PSA and c-PSA were measured in the 89 cases of PCa, 111 cases of BPH by Chemiluminescence analysis. Results The level of t-PSA was (3.6±2.4) ng/ml(BPH) and (15.2±16.2) ng/ml(PCa) (P<0.01). The false negative was 50.6% (cutoff= 10ng/ml) and 27.0% (cutoff =2.5ng/ml). The level of c-PSA was (0.08±0.06) ng/ml(BPH) and (28.9±37.6) ng/ml(PCa) (P<0.01), The false negative was 20.2% (cutoff =2.5ng/ml). When the cutoff of t-PSA was 2.5 ng/ml, to combine the c-PSA would raise the positive up to 69.7 %. Conclusion When the cutoff of t-PSA was 10.0 ng/ml, the c-PSA was significantly higher than t-PSA. We suggest adjust the cutoff of t-PSA to 2.5 ng/ml, and to combine the c-PSA would significant raise the Sensitivity and Specificity by diagnosis the prostate neoplasms.
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