电化学发光法检测前列腺癌特异性抗原标志物的研究

目的：探讨总前列腺特异性抗原（T-PSA）、游离前列腺特异性抗原（F-PSA）及 F-PSA/T-PSA 比值在前列腺癌及前列腺增生的诊断和鉴别诊断中的应用价值。方法收集病理确诊为前列腺癌患者86例、前列腺增生患者487例和健康体检者188例的血液样本，采用电化学发光法检测检测血清中 T-PSA、F-PSA 浓度，计算F-PSA/T-PSA 比值，比较 T-PSA、F-PSA 和 F-PSA/T-PSA 比值在前列腺癌组、前列腺增生组及正常对照组之间的差异。结果与正常对照组相比，前列腺增生组和前列腺癌组的 T-PSA、F-PSA、F-PSA/T-PSA 的比值差异具有高度统计学意义（p＆lt;0.01）；与前列腺增生组相比，前列腺癌组的 T-PSA、F-PSA、F-PSA/T- PSA 的比值差异也具有高度统计学意义（p〈0.01）。 T-PSA 在4.0～10.0 ng/mL 时，与前列腺增生组相比，前列腺癌组的 T-PSA 差异无显著性（p〈0.05），F-PSA 差异有显著性（p〉0.05），而 F-PSA/T- PSA 比值差异具有高度统计学意义（p〈0.01）。结论T-PSA 可作为前列腺癌筛选的一个重要的指标，当 T-PSA 在4.0～10.0 ng/mL 时，F-PSA/T-PSA 用于筛选前列腺癌优于 T-PSA，选择0.15作为 F-PSA/T-PSA 的临界值对前列腺癌诊断有较高的灵敏度和特异度。

Detection of prostate-specific antigen in patients with prostatic cancers by electrochemical luminescence

Objective：To investigate the value of detection of prostate-specific antigen T-PSA, F-PSA and F-PSA/T-PSA in the diagnosis and differential diagnosis of prostate cancer and prostatic hyperplasia. Methods：The blood samples of 86 prostate cancer patients, 487 prostatic hyperplasia patients and 188 healthy persons from Foshan First People＆#39;s Hospital were collected. The serum concentration of total prostate-specific antigen （T-PSA） and free prostate specific antigen （F-PSA）were examined by electrochemical luminescence. The F-PSA/T-PSA ratio was calculated. The significant difference of T-PSA, F-PSA and F-PSA/T-PSA ratio among the prostate cancer group, prostatic hyperplasia group and control group were calculated statistically and respectively. Results：The T-PSA, F-PSA, F-PSA/T-PSA ratio in the prostatic hyperplasia group and prostate cancer group was significantly different from those of the control group （p＆lt;0.01）. The T-PSA, F-PSA, F-PSA/T-PSA ratio in the prostate cancer group was significantly different from those of the prostatic hyperplasia group （p＆lt;0.01）. When the concentration of T-PSA ranged from 4.0 ng/ml to 10.0 ng/ml, there was no significant difference in the T-PSA between the prostate cancer group and the prostatic hyperplasia group, while the F-PSA and F-PSA/T-PSA ratio were significantly different between the two groups, When the＆amp;nbsp;concentration of T-PSA ranged from 4.0 ng/ml to 10.0 ng/ml, the F-PSA/T-PSA threshold take 0.1, 0.15, 0.16, 0.17, 0.2, respectively, the sensitivity was 33.3%, 61.9%, 61.9%, 69.0%, 76.2 %, respectively; the specificity was 89.1% , 70.1% , 64.7% , 60.0% , 44.6% , respectively. The critical value （0.15）was the best screening indicator. Conclusions：T-PSA can be used as an important screening indicator of prostate cancer. When concentration of T-PSA ranged from 4.0 to 10.0ng/ml, the F-PSA/T-PSA ratio was a better choice for prostate cancer screening than T-PSA, in which a higher sensitivity and specificity were achieved when