血清前列腺特异抗原和前列腺特异抗原密度对前列腺癌诊断价值评价.docVIP

血清前列腺特异抗原和前列腺特异抗原密度对前列腺癌诊断价值评价 【摘要】 目的 探讨血清前列腺特异抗原( PSA)及前列腺特异抗原密度( PSAD)在前列腺癌诊断及其与良性前列腺增生鉴别诊断中的价值。方法 采用化学发光免疫分析法检测前列腺癌患者(65例)和前列腺增生患者(116例)血清PSA水平，同时利用B超测定患者前列腺体积，计算出PSAD值，对患者进行分组比较。运用ROC曲线对PSA和PSAD诊断前列腺癌的价值进行分析。 结果 前列腺癌组与前列腺增生组患者在不同PSA区段和不同PSAD区段的分布差异均有非常显著性（P均0.01）。ROC曲线分析结果显示，PSA和PSAD的曲线下面积分别为0.948(95%CI:0.907～0.989)和0.971 (95%CI:0.944～ 0.999)。当PSA和PSAD临界值分别为4ng/ml和0.15时，敏感性分别为98.5%和96.9%，特异性分别为24.1%和63.8%；而当PSA和PSAD临界值分别为10ng/ml和0.20时，敏感性分别为95.4%和93.8%，特异性分别为67.2%和82.8%。 结论 PSA和PSAD在前列腺癌诊断及其与前列腺增生鉴别诊断中均有一定的价值；PSAD更能提高诊断前列腺癌的特异性和准确度，有利于前列腺癌与良性前列腺增生的鉴别诊断。 【关键词】 前列腺癌 前列腺特异抗原 前列腺特异抗原密度 【Abstract】 Objective To investigate the diagnostic value of serum prostate specific antigen (PSA) levels and PSA density (PSAD) for prostate carcinoma. Method Serum PSA levels were detected by chemiluminescent immunoassay(CLIA)in 65 patients with prostate carcinoma and 116 patients with benign prostatic hyperplasia. Prostatic volume was measured with B-type ultrasonography and PSAD was calculated. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of PSA and PSAD. Results Serum PSA levels and PSAD in patients with prostate carcinoma were significantly higher than those in patients with benign prostatic heperplasia（P0.001）. The AUC-ROC of PSA and PSAD was 0.948 (95%CI:0.907～0.989) and 0.971(95%CI:0.944～0.999) respectively, the sensitivity for PSA and PSAD was 98.5% and 96.9%, and the specificity was 24.1% and 63.8% at cutoff value of 4.0 ng/ml and 0.15 respectively. The sensitivity for PSA and PSAD was 95.4% and 93.8%, and the specificity was 67.2% and 82.8% at cutoff value of 10ng/ml and 0.20 respectively. Conclusion Both PSA and PASD have good value to detect prostatic carcinoma. PASD may improve the specificity and accuracy in the differential diagnosis of prostate carcinoma from benign prostatic hyperplasia, and is more helpful for the diagnosis. 【Key Words】 prostate cancer prostate specific antigen prostate specific antigen