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目的 :研究各年龄组正常人血清总前列腺特异性抗原 (TPSA)、游离前列腺特异性抗原 (FPSA)、前列腺酸性磷酸酶 (PAP)和F/TPSA比值的正常值范围以及与年龄的相关性 ,并探讨其联合应用在良性前列腺增生(BPH)和前列腺癌 (PC)鉴别诊断中的价值。方法 :采用酶放大化学发光法测定 89名正常志愿者、35例PC患者和 82例BPH患者血清TPSA、FPSA和PAP的水平 ,并计算F/TPSA的比值。结果 :4 1岁～ 88岁的正常人血清TPSA和FPSA水平与年龄有显著正相关性 (TPSA/年龄 :r=0 .4 4～ 0 .4 5 ,P <0 .0 1 ;FPSA/年龄 :r =0 .4 9～ 0 .5 1 ,P<0 .0 1 ) ;PC组和BPH组血清TPSA、FPSA和PAP水平明显高于正常对照组 (P <0 .0 1 ) ,而PC组F/TPSA比值则明显低于BPH组和正常人组 (P <0 .0 1 )。F/TPSA比值的分段研究显示 ,在TPSA轻、中度升高时 ,F/TPSA <0 .1提示PC可能性较大 (88 2 % ) ,而F/TPSA >0 .2 5时 ,表明PC可能性很小 (4 0 % )。结论 :4 0岁以上正常男性血清TPSA和FPSA水平随年龄升高而增加 ,并与年龄呈明显的正相关 ;TPSA、F/TPSA比值和PAP的联检可明显提高对PC和BPH诊断的准确性和特异性
Objective: To study the normal range of serum total prostate specific antigen (TPSA), free prostate specific antigen (FPSA), prostatic acid phosphatase (PAP) and F / TPSA ratio in all age groups and its correlation with age, And explore the value of its combined application in the differential diagnosis of benign prostatic hyperplasia (BPH) and prostate cancer (PC). Methods: Serum TPSA, FPSA and PAP levels were measured in 89 normal volunteers, 35 PC patients and 82 BPH patients by enzyme-enhanced chemiluminescence. The ratio of F / TPSA was calculated. Results: There was a significant positive correlation between serum TPSA and FPSA levels and age in 4-1-year-old to 88-year-old people (TPSA / age: r = 0.444-0.45, P <0.01; FPSA / age : r = 0.49 ~ 0.51, P <0.01). The levels of serum TPSA, FPSA and PAP in PC group and BPH group were significantly higher than those in normal control group (P <0.01) Group F / TPSA ratio was significantly lower than the BPH group and normal group (P <0. 01). Fragmentation studies of F / TPSA ratios showed that F / TPSA <0 .1 suggested a greater probability of PC (88 2%) at TES mild to moderate TPSA, while at F / TPSA> 0.52, Indicate PC is unlikely (40%). CONCLUSIONS: The levels of serum TPSA and FPSA in normal men over the age of 40 increase with age, and have a positive correlation with age. The joint examination of TPSA, F / TPSA ratio and PAP can obviously improve the diagnostic accuracy of PC and BPH And specificity