Objective To study the serum levels of PSA,PAP joint detection in the diagnosis of prostate cancer and the effect of estrogen.Methods 60 patients with prostate cancer were selected in department of urology of our hospital were given oral diethylstilbestrol 3 mg,once a day,and oral aspirin enteric-coated sustained release tablets 100 mg,once a day,for 2 consecutive months.At the same time,we selected 60 cases of benign prostatic hyperplasia,60 healthy subjects at the same period as normal control group.Detected serum PSA,PAP levels in prostatic hyperplasia group,normal control group,prostate cancer group before and after treatment with radioimmunoassay.Observed IPSS score in prostate cancer group before and after treatment.Results ① Serum PSA,PAP levels in prostate cancer group were (80.64±64.72)ng/ml,(45.86±55.73)ng/ml,significantly higher than (5.82±5.96)ng/ml,(1.35±0.92)ng/ml in prostatic hyperplasia group and (0.75±0.24)ng/ml,(0.79±0.61) ng/ml in normal control group,with statistically significant differences (P＜0.05);there were no statistically significant differences between prostatic hyperplasia group and normal control group (P＞0.05).② The positive detection rate and the detection sensitivity of PSA for prostate cancer was 78.33％,the specificity was 70％,the positive detection rate and the detection sensitivity of PAP for prostate cancer was 53.33％,the specificity was 93.33％;the positive detection rate and the detection sensitivity of PSA for prostate cancer was significantly higher than that of PAP,the specificity was lower,with statistically significant differences (P＜0.05).③ Serum PSA,PAP levels in prostate cancer group after treatment were (9.71±10.38)ng/ml,(7.82±11.77)ng/ml,decreased significantly compared with those before treatment,with statistically significant differences (P＜0.05).④ Prostate symptoms of prostate cancer group improved after treatment,IPSS score decreased significantly [(21.66±4.61) before treatment vs.(7.68±1.12) after treatment],with statistically significant difference (P＜0.05).Conclusions Combined detection of serum PSA,PAP in the diagnosis of prostate cancer can improve the sensitivity and specificity,and can be used for early diagnosis of prostate cancer;estrogen can lower their levels,improve the symptoms of prostate cancer,inhibit the progress of the disease.%目的 研究血清PSA、PAP联合检测对前列腺癌诊断的价值及雌激素对其的影响.方法 选取本院泌尿外科收治的前列腺癌患者60例,给予己烯雌酚3 mg,每日一次口服,同时给予阿司匹林肠溶缓释片100 mg,每日一次口服,连续2个月.同时选取前列腺增生患者60例,正常对照组为同时期体检健康者60例.采用放射免疫分析法,分别观察前列腺增生组、正常对照组、前列腺癌组治疗前、前列腺癌组治疗后血清PSA、PAP水平,以及前列腺癌组患者治疗前后IPSS评分指标.结果 ①前列腺癌组的血清PSA、PAP水平为(80.64±64.72)、(45.86±55.73) ng/ml,明显高于前列腺增生组的(5.82±5.96)、(1.35±0.92) ng/ml和正常对照组的(0.75±0.24)、(0.79±0.61) ng/ml,差异有统计学意义(P＜0.05);前列腺增生组和正常对照组比较差异无统计学意义(P＞0.05).②PSA对前列腺癌的阳性检出率及检测的灵敏性为78.33％,指标特异性达70.00％,而PAP对前列腺癌的阳性检出率及检测的灵敏性为53.33％,指标特异性达93.33％;PSA对前列腺癌检出的阳性率和灵敏性均高于PAP,而特异性却不及PAP,差异有统计学意义(P＜0.05);③治疗后,前列腺癌组血清PSA、PAP水平为(9.71±10.38)、(7.82±11.77) ng/ml,与治疗前比较,血清PSA、PAP水平明显下降,差异有统计学意义(P＜0.05);④治疗后,前列腺癌组前列腺症状有所改善,IPSS评分为(7.68±1.12),与治疗前的(21.66±4.61)比较,IPSS评分明显降低,差异有统计学意义(P＜0.05).结论 血清PSA、PAP联合检测能够提高对前列腺癌诊断的灵敏性和特异性,可用于前列腺癌的早期诊断;雌激素能够降低其水平,改善前列腺癌症状,抑制病情进展.
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