血清 PSA、PSAD 检测在前列腺癌骨转移诊断中的价值

摘要

Objective To investigate the clinical value of PSA , PSAS on prostate cancer with bone metastasis .Meth-ods A total of 238(a group of 112 cases of bone metastasis, a group of 126 cases of non-bone metastasis) patients with his-tologically diagnosed prostate cancer were analyzed .ECT, X-ray, CT and MRI were used to diagnose bone metastasis .Rela-tion among serum PSA and PSAD joint detection and bone metastasis were analyzed .Results According to serum PSA>20 ng/mL diagnostic criteria of bone metastasis , the rate of bone metastasis had significant difference between the two groups ( P<0.05), the sensitivity and specificity were 76.79%and 82.54%, respectively.According to serum PSAD>0.40 ng/(mL · cm3 ) diagnostic oriteria of bone metastasis , the rate of bone metastasis had significant differenc between the two groups ( P<0.05), the sensitivity and specificity were 82.14% and 75.40%, respectively.The sensitivity and specificity of serum PSA+PSAD were 82.14% and 84.13%, respectively .Using ROC curve to determine the diagnosis critical value of PCa bone metastases, the best critical value of serum PSA was 20 ng/mL and the best critical value of serum PSAD both 0.40 ng/( mL· cm3 ) .Conclusions Serum PSA and PSAD are both valuable parameters used in prediction of PCa bone metastasis . Serum PSA and PSAD joint detection can be better to help doctor predicting PCa bone metastasis .%目的：探讨血清前列腺特异性抗原（PSA）、前列腺特异性抗原密度（PSAD）检测在前列腺癌（PCa）骨转移诊断中的价值。方法经前列腺穿刺活检或手术后病理检查确诊的238例PCa患者，根据ECT、X线、CT及MRI结果诊断骨转移组112例、非骨转移组126例；分析血清PSA、PSAD水平与PCa骨转移的关系。结果以血清PSA＞20 ng／mL为骨转移诊断标准，两组骨转移阳性率有统计学差异（ P＜0．05），其诊断骨转移敏感度性76．79％，特异性为82．54％。以血清PSAD＞0．40 ng／（ mL· cm3）为骨转移诊断标准，两组骨转移阳性率有统计学差异（ P＜0．05），其诊断骨转移敏感性82．14％，特异性为75．40％。以血清PSA＞20 ng／mL 联合PSAD＞0．40 ng／（mL· cm3）为临界值诊断骨转移敏感性、特异性分别为82．14％和84．13％。应用ROC曲线确定诊断PCa骨转移的临界值，血清PSA为20 ng／mL， PSAD为0．40 ng／（mL· cm3）。结论血清PSA、PSAD均为判断PCa患者有无骨转移的可靠指标，PSA＋PSAD联合检测有助于预测PCa骨转移。