总前列腺特异性抗原及游离前列腺特异性抗原/总前列腺特异性抗原对高龄老年人前列腺癌的诊断与鉴别诊断

摘要

Objective To evaluate the application of t-PSA and f-PSA/t-PSA in the diagnosis and differential diagnosis of prostate cancer.Methods T-PSA and f-PSA of patients over 80 years old who were diagnosed of BPH or PCA pathologically by transrectal ultrasound guided biopsies were analyzed retrospectively.Results The ratio of patients with t-PSA≥4.0 μg/L is 85.5％ ( BPH 40.6％ , PCA 41.9％ ,others 3.0％) , and t-PSA≥10.0 μg/L is 59.4％ ( BPH 23.9％ , PCA 32.9％,others 2.6％).Among the paiients with t-PSA＜4.0 μg/L, there are 26 BPH and 6 PCA, and the average f-PSA/t-PSA of each is 0.26±0.14 and 0.24±0.13.Among 4.0≤t-PSA＜10.0 μg/L, 39 BPH and 21 PCA, and the average f-PSA/t-PSA of each is 0.26±0.09 and 0.11±0.06, respectively.Among t-PSA≥10.0 μg/L, 56 BPH and 77 PCA, and the average f-PSA/t-PSA of each is 0.25±0.07 and 0.13±0.05, respectively.Conclusion For the elder patients, there is no statistical significance to use t-PSA ≥4.0 μg/L or t-PSA≥10.0 μg/L for the diagnosis or differential diagnosis of BPH and PCA.For the patients with t-PSA≥10.0 μg/L and 4.0≤t-PSA＜10.0 μg/L, there is statistical significance for f-PSA/t-PSA between BPH and PCA.I%目的 探讨总前列腺特异性抗原(t-PSA)及游离前列腺特异性抗原(f-PSA)/t-PSA比值在高龄老年人(≥80岁)中的表现,并评价其在前列腺癌(PCA)和前列腺增生(BPH)鉴别诊断中的作用.方法 对经直肠超声引导下前列腺穿刺活检诊断为BPH和PCA的高龄患者234例,结合其术前的PSA检测结果,进行回顾性分析和统计.结果 t-PSA≥4.0 μg/L者高达85.5%(BPH 40.6%,PCA 41.9%,其他3.0%),而t-PSA≥10.0 μg/L者达59.4%(BPH 23.9%,PCA32.9%,其他2.6%).在t-PSA＜4.0 μg/L的患者中,BPH 26例,平均f-PSA/t-PSA值0.26±0.14;PCA 6例,平均f-PSA/t-PSA值0.24±0.13.4.0≤t-PSA＜10.0 μg/L的患者中,BPH 39例,平均f-PSA/t-PSA值0.26±0.09;PCA 21例,平均f-PSA/t-PSA值0.11±0.06.t-PSA≥10.0 μg/L的患者中,BPH 56例,平均f-PSA/t-PSA值0.25±0.07;PCA 77例,平均f-PSA/t-PSA值0.13±0.05.结论 对于高龄老年人,用t-PSA≥4.0 μg/L或t-PSA≥10.0 μg/L来鉴别BPH和PCA差异无统计学意义;对4.0≤t-PSA＜10.0 μg/L和t-PSA≥10.0 μg/L者,BPH和PCA患者的f-PSA/t-PSA值差异具有统计学意义.