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目的探讨结合前列腺特异性抗原(cPSA)在前列腺癌中的临床诊断意义。方法用化学发光免疫分析法检测前列腺癌(Pca)25例,前列腺增生(BPH)30例及正常对照组30例的血清总前列腺特异性抗原(tPSA)、cPSA和游离前列腺特异性抗原(fPSA)的浓度;计算f/tPSA比值并对tPSA、f/tPSA、cPSA进行统计学比较和ROC曲线分析。结果cPSA、tPSA在BPH组、Pca组分别与正常对照组比较均存在显著性差异(p<0.005),若以cPSA15.75ng/ml作为截断点诊断Pca,其敏感性、特异性、阳性预测值、实验有效率各参数均比较理想,分别为79.17%,92.86%,90.48%,88.46%。另tPSA,cPSA,fPSA三者在ROC曲线下的面积分别为tPSA>cPSA>f/tPSA。结论cPSA在鉴别前列腺增生和前列腺癌中具有较大的临床价值,建议临床以cPSA15.75ng/ml作为截断点,这能大幅度地提高cPSA对前列腺癌的检出率,减少或避免不必要的前列腺活检。
Objective To investigate the clinical significance of prostate-specific antigen (cPSA) in the diagnosis of prostate cancer. Methods Serum total prostate specific antigen (tPSA), cPSA and free prostate specific antigen (fPSA) were detected by chemiluminescence immunoassay in 25 cases of prostate cancer (Pca), 30 cases of benign prostatic hyperplasia (BPH) and 30 cases of normal control group. The ratio of f / tPSA was calculated and the statistical analysis and ROC curve analysis of tPSA, f / tPSA and cPSA were performed. Results The levels of cPSA and tPSA in BPH group and Pca group were significantly different from those in normal control group (p <0.005). The sensitivity, specificity and positive predictive value of cPSA15.75ng / ml as cut-off point , The experimental efficiency of the parameters are more ideal, respectively 79.17%, 92.86%, 90.48%, 88.46%. The areas under the ROC curves of tPSA, cPSA and fPSA were tPSA> cPSA> f / tPSA respectively. Conclusions cPSA has great clinical value in differentiating benign prostatic hyperplasia and prostate cancer. It is suggested that cPSA15.75ng / ml should be used as a cut-off point in clinic, which can greatly improve the detection rate of cPSA on prostate cancer, reduce or avoid unnecessary Prostate biopsy.