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目的探讨总前列腺特异性抗原(tPSA)4～10 ng/ml时其相关形式截点值,用于鉴别Ⅲ型前列腺炎与前列腺癌临床意义。方法前列腺癌69例,前列腺炎110例。采用全自动免疫荧光检测系统检测两组患者tPSA、游离PSA(fPSA),采用彩色多普勒超声诊断仪测量前列腺体积(PV)、移行区体积(TZV)、外周区体积(PZV),并计算前列腺特异性抗原密度(PSAD)、前列腺移行带特异性抗原密度(TZ-PSAD)、前列腺外周带特异性抗原密度(PZ-PSAD);对两组的PSA及其相关形式进行对比分析,寻找能够起鉴别作用的截点值。结果检出血清tPSA 4～10 ng/ml共127例,其中前列腺癌27例占21.3%(27/127);tPSA>10 ng/ml 52例,前列腺癌42例占80.8%(42/52)。前列腺癌组tPSA、PV、PZV、PSAD、PZ-PSAD明显高于前列腺炎组(P<0.05);两组fPSA、TZV、TZ-PSAD比较差异无统计学意义(P>0.05)。PSAD为0.20时,诊断前列腺癌的敏感性为88.4%,特异性为63.6%;PZ-PSAD为0.40时,诊断前列腺癌的敏感性为85.5%,特异性为72.7%。结论在tPSA4～10 ng/ml区域,利用f/tPSA和TZ-PSAD鉴别前列腺癌和前列腺炎意义不大,而PSAD、PZ-PSAD鉴别诊断有重要作用。
Objective To investigate the relevant cut-off value of total prostate-specific antigen (tPSA) in the range of 4 ~ 10 ng / ml to identify the clinical significance of type Ⅲ prostatitis and prostate cancer. Methods 69 cases of prostate cancer, 110 cases of prostatitis. TPSA and free PSA (PSA) were measured by automated immunofluorescence assay in both groups. Prostate volume (PV), transitional zone volume (TZV) and peripheral zone volume (PZV) were measured by color Doppler sonography. Prostate-specific antigen density (PSAD), Prostate transition zone specific antigen density (TZ-PSAD), Prostate peripheral zone specific antigen density (PZ-PSAD); PSA and its related forms were compared between the two groups to find the From the role of the cut-off point value. Results There were 127 cases of serum tPSA 4 ~ 10 ng / ml, of which 27.3% (27/127) had prostate cancer, 52 cases had tPSA> 10 ng / ml, and 42 cases (80.8%) had prostate cancer . The levels of tPSA, PV, PZV, PSAD and PZ-PSAD in prostate cancer group were significantly higher than those in prostatitis group (P <0.05). There was no significant difference in fPSA, TZV and TZ-PSAD between the two groups (P> 0.05). PSAD 0.20, the diagnosis of prostate cancer sensitivity was 88.4%, specificity was 63.6%; PZ-PSAD was 0.40, the diagnosis of prostate cancer sensitivity was 85.5%, specificity 72.7%. Conclusions There is no significant difference between tPSA4 ~ 10 ng / ml and f / tPSA and TZ-PSAD in differential diagnosis of prostate cancer and prostatitis. However, differential diagnosis of PSAD and PZ-PSAD plays an important role.