前列腺特异性抗原联合肿瘤异常蛋白对前列腺癌的诊断价值

王长春; 尹水平; 李家山; 朱士年; 李本光; 王辉; 关煜; 梁朝朝

doi:10.13201/j.issn.1001-1420.2019.10.008

前列腺特异性抗原联合肿瘤异常蛋白对前列腺癌的诊断价值

- 1. 安徽医科大学第一附属医院泌尿外科(合肥, 230000);
- 2. 肥西县三河医院泌尿外科
基金项目:
合肥市科技局“借转补”医疗卫生项目（编号81572350）

详细信息

通讯作者: 梁朝朝,E-mail:liang_chaozhao@163.com

中图分类号: R737.25

收稿日期: 2018-05-01

Clinical value of PSA combined with TAP in the diagnosis of prostate cancer

- 1. Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China;
- 2. Department of Urology, Feixi Sanhe Hospital

More Information

Corresponding author: LIANG Chaochao, E-mail: liang_chaozhao@163.com

Received Date: 01 May 2018

摘要

摘要: 目的：探讨前列腺特异性抗原（PSA）水平、游离PSA/总PSA（F/T）比值及肿瘤异常蛋白（TAP）3种肿瘤相关指标单独或联合诊断早期前列腺癌（PCa）的临床价值。方法：随机选取2016年10月~2017年10月安徽医科大学第一附属医院泌尿外科收治的120例PCa患者（PCa组）和192例良性前列腺增生患者（BPH组）为研究对象。所有纳入研究者均行血清PSA、游离PSA（f-PSA）及TAP水平的检测，并计算F/T比值。比较两组PSA水平、F/T比值以及TAP含量分布的差异，分析这3种指标单独或联合对PCa辅助诊断或早期诊断的灵敏度、特异度及准确度。结果：PCa组患者的血清PSA水平高于BPH组（P<0.001），而F/T比值小于BPH组（P<0.001）。PCa组的TAP阳性表达率明显高于BPH组（P<0.001）。PSA诊断PCa的灵敏度、特异度及准确度分别为85.83%、39.06%及57.05%，TAP诊断PCa的灵敏度、特异度和准确度分别为92.5%、49.48%和66.03%，PSA联合TAP诊断PCa的灵敏度、特异度和准确度分别为80.80%、67.19%和72.12%，其特异度和准确度高于单独PSA或TAP对PCa的诊断。TAP对PSA介于4~10 ng/ml灰区内PCa的诊断灵敏度高于F/T比值，特异度及准确度均低于F/T比值，但约登指数高于F/T比值。结论：PSA联合TAP诊断PCa具有灵敏度、特异度和准确度高的特点，对PCa的早期筛查及诊断具有一定临床价值。
- 前列腺特异性抗原 /
- 肿瘤异常蛋白 /
- 前列腺癌 /
- 诊断价值
Abstract: Objective: To investigate the clinical value of prostate specific antigen(PSA), free PSA/total PSA(f-PSA/t-PSA) ratio, and tumor abnormal protein(TAP) independently and jointly in diagnosing prostate cancer. Method: One hundred and ninety-two cases of prostatic hyperplasia(BPH) and 120 cases of prostate cancer(PCa) hospitalized in the Department of Urology of First Affiliated Hospital of Anhui Medical University from October 2016 to October 2017 were randomly selected and recruited in the study. The levels of serum PSA, f-PSA and TAP were tested and f-PSA/t-PSA ratio was calculated. The difference in the distribution of PSA, f-PSA/t-PSA, and TAP in the two groups were analyzed. The sensitivity, specificity, and accuracy of PSA, TAP, PSA with TAP, and PSA with f-PSA/t-PSA ratio in diagnosing PCa were compared. Result: The serum PSA level in patients of PCa group was higher than that of BPH group(P<0.001), while the F/T ratio was lower than that of BPH group(P<0.001). The positive expression rate of TAP in PCa group was significantly higher than that in BPH group(P<0.001). The sensitivity, specificity, and accuracy of PSA in diagnosing PCa were 85.83%, 39.06%, and 57.05%, while for TAP were 92.5%, 49.48%, and 66.03%, respectively. The sensitivity, specificity, and accuracy of PSA with TAP in diagnosing PCa were 80.80%, 67.19%, and 72.12%, respectively; the specificity and accuracy of PSA with TAP were higher than those of single PSA or TAP. The sensitivity of TAP in diagnosing PCa with serum PSA level in gray area(4-10 ng/ml) was higher than that of F/T ratio; the specificity and accuracy of TAP were lower than those of F/T ratio, while the Youden index of TAP was higher than that of F/T ratio.Conclusion: The combination of PSA and TAP has high sensitivity, specificity, and accuracy in diagnosing PCa, which is benefit to the screening of PCa in clinic.
- prostate specific antigen /
- tumor abnormal protein /
- prostate cancer /
- diagnostic value

HTML全文

参考文献(22)

[1]	Caini S, Gandini S, Dudas M, et al.Sexually transmitted infections and prostate cancer risk:A systematic review and meta-analysis[J].Cancer Epidemiol, 2014, 38(4):329-338.
[2]	Nesvadba M, Cmorej P, Mamova A, et al.The incidence, mortality and risk factors of prostate cancer[J].Epidemiol Mikrobiol Imunol, 2016, 65(4):211-214.
[3]	杨进益, 杨明州, 魏伟, 等.前列腺癌发生发展的流行病学研究进展[J].临床泌尿外科杂志, 2017, 32(9):721-725.
[4]	曹希亮, 高江平, 许承斌, 等.前列腺穿刺病理组织学类型在不同PSA水平中的分布[J].临床泌尿外科杂志, 2007, 22(2):109-112.
[5]	蒋珺, 陈亚青, 朱云开, 等.不同部位前列腺癌超声造影增强程度的定量研究[J].中华超声影像学杂志, 2012, 21(11):977-981.
[6]	陆殿元, 沈理, 蔡建荣, 等.超声造影对于不同PSA含量前列腺癌诊断的临床价值[J].中华男科学杂志, 2018, 24(1):50-54.
[7]	Xie S W, Li H L, Du J, et al.Influence of serum prostate-specific antigen(PSA)level, prostate volume, and PSA density on prostate cancer detection with contrast-enhanced sonography using contrast-tuned imaging technology[J].J Ultrasound Med, 2013, 32(5):741-748.
[8]	翟玉普, 闫成全.多种肿瘤标志物联合前列腺特异度抗原检测在前列腺癌诊断中的价值[J].中国性科学, 2016, 25(8):7-10.
[9]	邴振, 卢愿, 孙立荣, 等.异常糖链糖蛋白在肿瘤发生发展中的作用及检测进展[J].齐鲁医学杂志, 2015, 30(2):245-246.
[10]	王福利, 符生苗, 邓立群, 等.前列腺癌血清诊断标志物研究进展[J].海南医学, 2010, 21(22):12-15.
[11]	袁泉良, 屈中玉, 任东方.血清PSA、ALP与OC联合检测在前列腺癌骨转移中的临床意义[J].中国卫生检验杂志, 2015, 25(23):4087-4089.
[12]	段秀枝, 陶志华.PCA3基因与前列腺癌的诊断及其应用价值研究[J].中华检验医学杂志, 2016, 39(8):568-570.
[13]	Zhang X S, Zhang Y, Wu P X, et al.Early diagnosis of prostate cancer by combined use of Trp-p8 expression and PSA density of the transition zone[J].Zhonghua Nan Ke Xue, 2015, 21(8):724-728.
[14]	奚春.多种血清肿瘤标志物联合前列腺特异度抗原检测在前列腺癌诊断中的价值分析[J].中国卫生检验杂志, 2017, 27(24):3585-3587.
[15]	赵乔妹, 时宇, 张静, 等.联合检测F-PSA、T-PSA及F-PSA/T-PSA比值在前列腺疾病诊断中的意义[J].标记免疫分析与临床, 2015, 22(6):487-489.
[16]	Toktas G, Demiray M, Erkan E, et al.The effect of antibiotherapy on prostate-specific antigen levels and prostate biopsy results in patients with levels 2.5 to 10 ng/ml[J].J Endourol, 2013, 27(8):1061-1067.
[17]	王炜, 李传刚, 刘辉, 等.前列腺特异性抗原对前列腺癌诊断价值的探讨[J].中国医科大学学报, 2016, 45(1):61-65.
[18]	Greene K L, Albertsen P C, Babaian R J, et al.Prostate specific antigen best practice statement:2009 update[J].J Urol, 2013, 189(1 supp1):S2-S11.
[19]	Zhang L, Guo X, Min Y, et al.Tumor abnormal protein(TAP)examination contributes to primary diagnosis of bladder cancer[J].Int J Clin Exp Med, 2015, 8(10):18528-18532.
[20]	曹奎杰, 刘燕婕.卵巢上皮癌患者ABO血型抗原表达异常与血清糖链蛋白水平的关系[J].中华检验医学杂志, 2010, 33(3):267-268.
[21]	戴美珍, 陈雪娇, 章鸯, 等.肿瘤异常蛋白检测的临床应用分析[J].中国卫生检验杂志, 2016, 26(21):3149-3151.
[22]	施南峰.肿瘤异常蛋白(TAP)筛查早期恶性肿瘤应用研究[J].中国公共卫生管理, 2010, 26(2):187-189.