Comparisons of the Various Combinations of Free, Complexed, and Total Prostate–Specific Antigen for the Detection of Prostate Cancer
Comparisons of the Various Combinations of Free, Complexed, and Total Prostate–Specific Antigen for the Detection of Prostate Cancer
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DOI：
10.1159/000020312
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发表时间：
2000-09
期刊：
影响因子：
23.4
通讯作者：
T. Okegawa;H. Noda;K. Nutahara;E. Higashihara
中科院分区：
文献类型：
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作者：
T. Okegawa;H. Noda;K. Nutahara;E. Higashihara
目的：我们比较了三种前列腺特异性抗原（PSA）比值-游离PSA与总PSA比值-（fPSA/tPSA），游离与复合PSA比值（fPSA/cPSA）和复合PSA/总PSA比值前列腺特异性抗原（cPSA）/前列腺特异性抗原（tPSA）-以区分前列腺癌和良性前列腺增生（BPH）。我们测试了258名接受经直肠超声检查的连续患者-由于直肠指检异常或Tandem-R PSA>4.1 ng/ml而导致引导前列腺穿刺活检。通过Tandem-R测定法测量游离PSA（fPSA）和总PSA（tPSA）。结果：258例患者中，BPH 204例，前列腺癌54例。fPSA/tPSA、fPSA/cPSA和cPSA/tPSA在96%灵敏度下的特异性分别为23、25和33%。在162名tPSA在4.1和10.0 ng/ml之间的患者中，132名患有BPH，30名患有前列腺癌。f/tPSA、f/cPSA和c/tPSA在96%灵敏度下的特异性分别为32%、44%和41%。在总体PSA范围内或tPSA在4.1和10.0 ng/ml之间，fPSA/tPSA、fPSA/cPSA和cPSA/tPSA之间的受试者工作特征曲线下面积无显著差异。结论：fPSA/tPSA、fPSA/cPSA和cPSA/tPSA在区分前列腺癌和BPH的能力上无差异。
Objectives: We compared the ability of three prostate–specific antigen (PSA) ratios – free–to– total PSA ratio (fPSA/tPSA), free–to–complexed PSA ratio (fPSA/cPSA), and complexed–to–total PSA ratio (cPSA/tPSA) – to distinguish prostate cancer from benign prostatic hyperplasia (BPH).Methods: We tested 258 consecutive patients who underwent transrectal ultrasound–guided prostate needle biopsy because of an abnormal digital rectal examination or a Tandem–R PSA of >4.1 ng/ml. Free PSA (fPSA) and total PSA (tPSA) were measured by Tandem–R assay. α1–Antichymotrypsin–complexed PSA (cPSA) was measured by Markit–M PSA–ACT assay.Results: Of the 258 patients, 204 had BPH, and 54 had prostate cancer. The specificity at 96% sensitivity for fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA was 23, 25, and 33%, respectively. Of 162 patients with tPSA between 4.1 and 10.0 ng/ml, 132 had BPH and 30 had prostate cancer. The specificity at 96% sensitivity for f/tPSA, f/cPSA and c/tPSA was 32, 44, and 41%, respectively. There was no significant difference in the area under the receiver–operating characteristic curves among fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA in the overall PSA range or in tPSA between 4.1 and 10.0 ng/ml.Conclusion: fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA did not differ in their ability to distinguish prostate cancer from BPH.