本地区前列腺癌与前列腺增生患者f-psat-psa的变化-changes of f - psat - psa in patients with prostate cancer and prostatic hyperplasia in this region.docxVIP

山西医科大学硕士学位论文本地区前列腺癌与前列腺增生患者f-PSA／T-PSA的变化 摘要目的：探讨处于灰区阶段患者f-PSA／T—PSA在前列腺癌与前列腺增生鉴别诊断中的作用。材料和方法：收集山西医科大学第二临床医学院2007年2月一2008年2月住院的前列腺癌 和前列腺增生患者，选择血清总前列腺特异性抗原(4．0-10．0)IJ g／1的30例经直肠B超 引导下前列腺系统穿刺活检证实为前列腺癌的患者和40例经检查证实为前列腺增生的患 者，采用贝克曼公司的Access全自动化学发光免疫分析仪及贝克曼诊断试剂公司的检测 试剂，检测血清中总前列腺特异性抗原(T-PSA)和游离态前列腺特异性抗原(f-PSA)， 计算f／T比值，将f／T比值分为O．12，0．18，O．26三个区间，分析两组患者血清f／T比 值介于不同区间的百分比及鉴别前列腺良恶性疾病时的敏感性和特异性。结果：T-PSA在(4．O一10．O)u g／1，组间T-PSA浓度无显著性差异(P0．05)，组间f-PSA 有显著性差异(PO．01)，f／T比值有显著性差异(PO．05)，当f／T比值0．12时，鉴别前列 腺良恶性病变特异性为90．91％，敏感性为33．33％：当f／T比值O．18时，鉴别前列腺良恶性 病变特异性为85．19％，敏感性为76．67％：当f／T比值0．26时，鉴别前列腺良恶性病变特异 性为41．18％，敏感性为93．33％。结论：当T-PSA位于(4．0—10．0)l-t g／1时，同时测定f-PSA并应用f／T比值鉴别前列腺 癌与前列腺增生明显优于单纯应用T-PSA，本地区患者f／T比值为0．18时提高了对前列腺 癌诊断灵敏性和特异性。关键词：前列腺癌，前列腺增生，T-PSA，f-PSA，f／T比值山西医科大学硕士学位论文IN 0UR REGION THE CHANGES OF F．PSA／T．PSA BETWEENPROSTATE CANCER AND PROSTATE HYPERPLASIA PATIENTAbstract objectiveWe investigated the contribution of f-PSA／T—PSA tO diagnose in disheartened area stagepatients between prostate cancer and the prostate hyperplasia．Materials and Methods腑collected the prostate cancer and prostate hyperplasia patient being in hospitalfrom in February 2007 to in February 2008 in second clinical Shanxi medical college，30 examples for prostate cancer patient whose the general serum prostate specificity antigen is in 4．0-10．0 mug／!by making biopsy under rectum B-ultrasonography guiding tO confirm and 40 examples for prostate hyperplasia whose the general serum prostate specificity antigen is in 4．0-10．0 mug，l by checking up to confirm．We adopt Access entire automaticluminescence immunity analysis instrument of Beikeman company and diagnose reagent ofBeikeman company to detect the general serum prostate specificity antigen(T-PSA)and the free state prostate specificity antigen(f-PSA)and calculate f／T ratio，We divided ratio into three intervals which were lower than 0．12，lower than 0．18，lower than 0．26 to analyse thepercentage，the sensibility and specificity of distinguishing the prostate good m