前列腺特异性抗原检测与前列腺疾病相关性分析
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【摘要】 目的 前列腺特异性抗原(PSA)是检测前列腺癌和鉴别前列腺增生与前列腺癌的重要指标，近年来前列腺特异性抗原相关指标游离PSA(fPSA)与总 PSA(tPSA)及fPSA/tPSA的应用极大提高了前列腺癌的诊断率。由于tPSA、fPSA测定值的高低与测定方法密切相关，不同的方法会导致不同的结果。我们采用电化学发光免疫分析技术对其进行测定，从而找出血清中tPSA检测值在4～10 ng/ ml之间的前列腺增生和前列腺癌患者fPSA/ tPSA比值的临界值，为临床诊断前列腺癌提供依据。方法 采用Roche Elecsys E170电化学发光免疫检测仪，分别测定其tPSA、fPSA，计算fPSA /tPSA的比值。结果 前列腺癌与前列腺增生相比fPSA/tPSA的比值明显减低，差异有统计学意义(P<0.01)。结论 使用电化学发光免疫试剂时以<0.15作为fPSA/tPSA临界值，为前列腺癌早期发现、监测及预后提供可靠的诊断依据。
【关键词】 前列腺特异性抗原;免疫分析法;前列腺增生;前列腺癌
Analysis the relativity between prostate specific Antigen and prostate disease SUN Chun-xia. Department of Laboratory, General Hospital of Pingmei Group, Pingdingshan 467000, China
【Abstract】 Objective Prostate Specific Antigen(PSA)is an important indicator of detecting prostate cancer, and also the important identification of benign prostatic hyperplasia and prostate cancer. In recent years, the application of free PSA(fPSA), total PSA(tPSA)and fPSA / tPSA making the diagnosis of prostate cancer a great improvement. As the measured values of tPSA and fPSA is closely related to the determining methods, different methods lead to different results. For providing the basis for clinical diagnosis of prostate cancer, we determining by using the electrochemiluminescence immunoassay to find benign prostatic hyperplasia and prostate cancer patients whose value of tPSA in the serum is among 4～10 ng/ml, and then find out their thresholds of fPSA/tPSA.Methods By using the Roche ElecsyeE170 electrochemiluminescence immunoassay detector, measured the values of tPSA and fPSA, then calculated the ratios of fPSA /tPSA.Results Comparing the values of fPSA /tPSA between the patients with prostate cancer and the patients with benign prostatic hyperplasia, the former was lower significantly. And this difference had great significance in the diagnosis(P<0.01). Conclusion Regarded <0.15 as the threshold of fPSA/tPSA when using the electrochemiluminescence immunoassay kit in the detections. This approach provided a reliable basis for early detecting, monitoring and preventing the prostate cancer.
【Key words】 Prostate specific antigen;Immunoassay; Prostatic hyperplasia; Prostate cancer
PSA是目前少数器官特异性肿瘤标志物，也是前列腺癌最具有的诊断意义的标志物[1]。但由于其不具备肿瘤特异性，当前列腺良性增生时PSA也会上升，与前列腺癌在4～10 ng/ml之间形成一交叉重叠区域[2]。随着检测技术的发展,单纯PSA检测已不能满足临床诊断需求。电化学发光免疫测定ECLIA技术应用，既具有电发光检测的高度敏感性，又具有免疫分析的高度特异性。因其快速、准确、重复性好、灵敏度高及试剂安全无毒等特点，显出良好的应用前景[3]。使得tPSA、fPSA结果更准确可靠。通过计算fPSA/ tPSA的比值，找出前列腺癌与前列腺增生诊断的临界值，为临床提供诊断依据。
1 临床资料
前列腺增生患者65例，前列腺癌患者33例，平均年龄(65.50±12.60)岁。所有病例均经病理和临床证实，血清tPSA在4～10 ng/ml之间。正常对照组90例，平均年龄(47.4±8.60)岁，为我院健康查体中心查体人员，无前列腺疾病。
2 方法与试剂
采用Roche Elecsys E170电化学发光免疫检测仪以及配套试剂，检测范围tPSA为0.003～100 ng/ml、fPSA为0.010～50.00 ng/ml。取材前一周禁止直肠指检、前列腺按摩，空腹静脉采血3 ml、不抗凝。37℃水浴30 min以上待血液完全凝固后分离血清检测。
3 结果 见表1、2。
表1 正常人、前列腺增生、前列腺癌患者血清中fPSA、tPSA含量与比值(x±s,ng/ml)
注：t值为前列腺增生与前列腺癌患者测定结果的比较
表2 设定fPSA/tPSA比值与灵敏度和特异性的关系
4 讨论
前列腺特异性抗原(Prostatespecific antigen，PSA)是由前列腺上皮细胞合成分泌[4] ......
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