前列腺癌论文前列腺癌患者血清EPCAPSA水平的相关研究.doc

前列腺癌论文：前列腺癌患者血清EPCA、PSA水平的相关研究 【中文摘要】探讨前列腺癌患者血清早期前列腺癌抗原(EPCA)、总前列腺特异性抗原(tPSA)、游离型／总PSA(f/tPSA)与Gleason评分、临床分期的相关性及其在前列腺癌(PCa)诊断及鉴别诊断中的临床应用价值。方法：采用时间分辨荧光免疫分析法(TRFIA)检测30例前列腺癌、45例良性前列腺增生(BPH)及36例前列腺正常对照组患者血清中tPSA、游离型PSA(fPSA)表达水平,并计算出f/tPSA值：采用酶联免疫吸附法(ELISA)检测上述患者血清EPCA水平并结合临床病理资料进行统计学分析。结果：(1)EPCA血清水平在前列腺癌组与前列腺增生组、正常对照组比较差异具有统计学意义(P0.05)。(3)前列腺癌组f/tPSA明显低于前列腺增生组及正常对照组(P0.05)。(4)ROC曲线下面积从大到小依次为EPCAf/tPSAtPSA。在诊断敏感度相同的情况下,EPCA诊断特异度明显高于tPSA和f/tPSA的诊断特异度。当EPCA临界值取9.94ng/ml时,诊断前列腺癌的敏感度和特异度分别为(90%和97.5%), f/tPSA临界值取0.16时,其敏感度和特异度分别为(63.3%和76.5%)。(5)30例前列腺癌患者中,前列腺癌血清tPSA水平与Gleason评分呈正相关(r=0.475,P=0.000),与前列腺癌临床分期呈正相关(r=0.589,P=0.000); f/tPSA与Gleason评分呈弱负相关(r=-0.102,P=0.045)与前列腺癌临床分期呈负相关(r=-0.216,P=0.019); EPCA与Gleason评分无相关(P0.05), EPCA与前列腺癌临床分期无相关(P0.05)。结论：(1)检测前列腺癌患者血清EPCA水平能明显提高前列腺癌诊断率,有助于前列腺癌与BPH的鉴别诊断,以减少BPH不必要的穿刺活检。(2)血清tPSA、f/tPSA与前列腺癌的Gleason评分和临床分期有相关性。 【英文摘要】:To evaluate the relationships between Gleason score,clinical stages and early prostate cancer antigen (EPCA),total PSA,free-to-total prostate specific antigen ratio (f/tPSA) in patients with prostate cancer.To discuss its value of diagnosisd and differential diagnosis in the clinical application.Methods:The levels of serum total PSA,free PSA were detected by TRFIA in 30 prostate cancer patients,45 benign prostatic hyperplasia(BPH) patients and 36 normal subjects.The method of ELISA was used to measure the serum concertration of EPCA in these people.Results:(1)Serum EPCA levels in the prostate cancer were significantly higher than that in BPH patients and normal subjects (P0.05).(3)The f/tPSA ratio in the prostate cancer were significantly lower than that in BPH group and normal patitents(P0.05).(4)The area under ROC curve of three indexes in decending order was EPCA and f/tPSA ratio,tPSA.The specificity of EPCA were significantly higher than that of tPSA and f/tPSA under the same sensitivity. When the cutoff of EPCA and f/tPSA were 9.94 and 1.6,the