The Value Of Diagnosis About PSA And Related Markers In Prostate Adenocarcinoma

The Prostate specific antigen (PSA) was found in the 1960s. Many prostate cancer marks was found after PSA was used in Clinic in 1980s. Now, PSA is still an indispensable tumor mark for screening or diagnosing prostrate adenocarcinoma (PCa). And it is widely used. Although PSA has high sensitivity and specificity, many problems have been found in clinic use. For example, the differential diagnosis between benign prostatic hyperplasia (BPH) and PCa, when total prostatic specific antigen(t-PSA) is about 4-10ng/ml. Along with deep research, free prostatic specific antigen (f-PSA) , f-PSA/t-PSA (f/t-PSA) , prostatic specific antigen density (PSAD) is used to remedy the deficiency of t-PSA.ObjectiveTo investigate the serum levels of t-PSA, f-PSA, f/t-PSA, prostate volume(PV) and PSAD, find the significance to diagnosis and differential diagnosis of BPH and PCa.Objects and MethodsWe collected about 204 patients with BPH and 148 patients with PCa who were in the first appendent hospital of Zhejiang University form 2003-1 to 2006-2. Serum t-PSA, f-PSA, f/t-PSA, Transcrectal Ultrasound(TRUS) or type-B ultrasonic test of prostate were collected for every patients. Figure out the PV and PSAD. Analyze the data of t-PSA, f-PSA, f/t-PSA and PSAD between the group of BPH and PCa, also analyze the relationship between age and the data of t-PSA, f-PSA, f/t-PSA and PSAD in one group.Results1. Serum t-PSA and f-PSA levels and PV of 204 patients with BPH increased with age and there were positive correlations(P<0.01), but f/t-PSA ratio and PSAD didn't correlate with age(P>0.05).2. Serum t-PSA level, PV and PSAD of 148 patients with PCa increased with age and there were positive correlations (P<0.01), but f-PSA level and f/t-PSA ratio didn't correlate with age(P>0. 05).3. The levels of t-PSA, f-PSA and PSAD were high in the group of PCa (P<0. 01).4. The scale of PCa increased with age and there were positive correlations (P<0.01).5. The sensitivity and specificity of t-PSA was 84.46% and 58.33%, the sensitivity and specificity of PSAD was 79. 05% and 93. 14%.ConclusionSerum t-PSA is still the specific tumor mark of PCa. Combined determination of t-PSA, f-PSA , f/t-PSA and PSAD can enhance the sensitivity and specificity for diagnosis of BPH and PCa.