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目的 探讨血清前列腺特异抗原 (PSA)及其密度 (PSAD)及移行带密度 (PSA TZ)在前列腺癌筛选中的意义。 方法 回顾性分析 15 3例血清PSA <2 0ng/ml的因怀疑前列腺癌而进行前列腺穿刺活检的患者 ,对PSAD及PSA TZ与活检结果进行分析。 结果 活检结果前列腺增生 (BPH)10 0例 ,前列腺癌 (PCa) 5 3例。BPH和PCa组平均PSAD分别为 (0 13± 0 11)和 (0 30± 0 2 1)ng·ml-1·ml-1,PSA TZ分别为 (0 2 6± 0 2 0 )和 (0 78± 0 71)ng·ml-1·ml-1,PCa组明显升高 ,均为P <0 0 1。以前列腺体积 5 0ml或移行带体积 2 5ml为界 ,体积较小BPH和PCa组间的平均PSAD和PSA TZ差异更明显。PSAD及PSA TZ的ROC曲线下面积 (分别为 0 73及 0 74)明显大于PSA(0 5 7) ,但两者间差异无显著性。 结论 当血清PSA <2 0ng/ml时 ,PSAD及PSA TZ在前列腺癌的筛选中要优于PSA ,但应根据前列腺或移行带体积调整他们的临界值
Objective To investigate the significance of serum prostate specific antigen (PSA) and its density (PSAD) and transitional zone density (PSA TZ) in the screening of prostate cancer. Methods We retrospectively analyzed the results of PSAD, PSA TZ and biopsy in 15 3 patients with PSA <20 ng / ml who underwent prostate biopsy for suspected prostate cancer. Results Biopsy results of BPH (10 cases) and prostate cancer (PCa) 53 cases. The average PSAD in BPH and PCa groups were (0 13 ± 0 11) and (0 30 ± 0 2 1) ng · ml -1 · ml -1, respectively, and PSA TZ were (0 26 ± 0 2 0) and 0 78 ± 0 71 ng · ml-1 · ml-1, the PCa group was significantly increased, all P <0 01. The prostate volume of 50ml or transition zone volume of 25ml boundary, the smaller the average BPH and PCa group average PSAD and PSA TZ differences more pronounced. The area under the ROC curve of PSAD and PSA TZ (0 73 and 0 74, respectively) was significantly greater than PSA (0 57), but there was no significant difference between them. Conclusions PSAD and PSA TZ are superior to PSA in the screening of prostate cancer when serum PSA is less than 20 ng / ml, but their cut-off value should be adjusted according to the volume of prostate or transition zone