| Objective:To investigate the serum levels of total prostatic specific antigen (T-PSA), F/T, PSAD and related markers in diagnosis and differential diagnosis of prostate cancer(PCa) and benign prostate hyperplasia (BPH). To recommend the best cut-off point of PSAD and F/T to do prostate biopsy or not.Methods:We collected the datas of about 350 patients with BPH and 184 patients with PCa who were admitted in General Hospital of Tianjin Medical University from Jan, 2004 to Dec,2009. Serum T-PSA, F- PSA, transrectal ultrasonography examination (TRUS) of prostate and age were collected for every patients. The value of F/T, prostate volume(PV) and PSAD were figured out. We analyzed and compared the data of T- PSA, F/T and PSAD between the group of BPH and PCa, and figured out the sensitivity, specificity, positive predictive value (PV+) and negative predictive value (PV-) of PCa when PSAD and F/T value were different.Results:1. The levels of serum TPSA, F/T and PSAD of patients with BPH and PCa have significant difference (P<0.05).2. When TPSA has limited specificity in the gray area (4～10ng/ml), F/T of PCa were significantly lower than that of BPH (P＜0.05), PSAD of PCa were significantly higher than that of BPH (P＜0.05)3. When TPSA was in 4～10ng/ml, and F/T≤0.16 was took as the cut-off value, the sensitivity of PCa was 81.0%, the specificity of PCa was77.4%, the positive predictive value (PV+) was 91.2%, the negative predictive value (PV-) was 58.5%, prostate biopsy was recommended when F/T≤0.16;PSAD> 0.15 was took as the cut-off value, the sensitivity of PCa was 78.2%, the specificity of PCa was 85.5%, the positive predictive value(PV+) was 94.0%, the negative predictive value(PV-) was 81.3%. PSAD could enhance the sensitivity and specificity for diagnosis of PCa. Combining the F/T and PSAD in diagnosis of PCa, the specificity of diagnosis could be increased from 77.4% to 85.5% and the sensitivity of diagnosis had no significant variation.Conclusions:The results of this study showed, F/T and PSAD data both had higher diagnosis and differential diagnosis value in prostate cancer (PCa) than tPSA, especially for the patients whose tPSA was between 4-10ng/ml. Using PSA data F/T and PSAD, the sensitivity, specificity and PV+ of diagnosis of PCa could be increased, and thus could reduce the unnecessary prostate biopsies. |
