PSA、FPSA和FPSA/PSA与前列腺癌骨转移的相关性研究
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摘要
目的探讨血清总前列腺特异性抗原(PSA)、血清游离前列腺特异性抗原(FPSA)和FPSA/PSA比值与前列腺癌(PCa)骨转移的关联性。方法选取2015年3月～2018年12月收治的前列腺癌患者128例,经核素骨显像后分为无骨转移组56例和骨转移组72例;另取同期良性前列腺增生(BPH)患者、健康男性体检者各56例作对照,检测各组对象血清PSA、FPSA水平,并进行组间对比分析。结果 PCa患者的PSA、FPSA水平高于PCa无骨转移组、BPH组及对照组(P<0.05或0.01);PCa患者的FPSA/PSA明显低于BPH患者及健康体检者(P<0.05),而PCa骨转移组与PCa无骨转移组的FPSA/PSA比值差异无统计学意义(P>0.05)。前列腺疾病恶化与PSA水平值呈正相关(r=0.516,P<0.05),前列腺癌骨转移与PSA水平值呈正相关(r=0.494,P<0.05);前列腺疾病恶化与FPSA水平值呈正相关(r=0.442,P<0.05),前列腺癌骨转移与FPSA水平值呈正相关(r=0.438,P<0.05);FPSA/PSA与前列腺疾病恶化无统计学相关性(r=-0.108,P>0.05)。结论 PSA、FPSA水平值与前列腺癌骨转移呈正相关,FPSA/PSA比值下降对前列腺恶变有诊断意义,PSA、FPSA与FPSA/PSA三者联合检查对前列腺癌骨转移诊断有重要参考价值。
Objective To investigate the association of serum total prostate specific antigen(PSA),free prostate specific antigen(FPSA) and FPSA/PSA ratio with bone metastasis of prostate cancer(PCa).Methods 128 patients with PCa admitted to hospital from March 2015 to December 2018 were divided into non-bone metastasis group(56 cases) and bone metastasis group(72 cases) after radionuclide bone imaging.At the same time,56 patients with benign prostatic hyperplasia(BPH) and 56 healthy men were taken as controls.And then,serum PSA and FPSA levels were detected and compared among groups.Results The levels of PSA and FPSA in PCa patients were significantly higher than those in the PCa non-bone metastasis group,BPH group and control group(P<0.05 or 0.01).The FPSA/PSA ratio in PCa patients was significantly lower than that in BPH patients and healthy persons(P<0.05),but there was no statistically significant difference in the FPSA/PSA ratio between PCa bone metastasis group and PCa non-bone metastasis group(P>0.05).Prostate disease deterioration was positively correlated with PSA level(r=0.516,P<0.05),and bone metastasis of PCa was positively correlated with PSA level(r=0.494,P<0.05).The prostate disease deterioration was positively correlated with the FPSA level(r=0.442,P<0.05),and the bone metastasis of PCa was positively correlated with FPSA level(r=0.438,P<0.05).And there was no statistical correlation between FPSA/PSA and prostate disease deterioration(r=-0.108,P>0.05).Conclusion The levels of PSAand FPSA are positively correlated with bone metastasis of prostate cancer.The decrease of FPSA/PSA is of diagnostic significance for malignant transformation of prostate.The combined detection of PSA,FPSA and FPSA/PSA has important reference value for the diagnosis of bone metastasis of prostate cancer.
Objective To investigate the association of serum total prostate specific antigen(PSA),free prostate specific antigen(FPSA) and FPSA/PSA ratio with bone metastasis of prostate cancer(PCa).Methods 128 patients with PCa admitted to hospital from March 2015 to December 2018 were divided into non-bone metastasis group(56 cases) and bone metastasis group(72 cases) after radionuclide bone imaging.At the same time,56 patients with benign prostatic hyperplasia(BPH) and 56 healthy men were taken as controls.And then,serum PSA and FPSA levels were detected and compared among groups.Results The levels of PSA and FPSA in PCa patients were significantly higher than those in the PCa non-bone metastasis group,BPH group and control group(P<0.05 or 0.01).The FPSA/PSA ratio in PCa patients was significantly lower than that in BPH patients and healthy persons(P<0.05),but there was no statistically significant difference in the FPSA/PSA ratio between PCa bone metastasis group and PCa non-bone metastasis group(P>0.05).Prostate disease deterioration was positively correlated with PSA level(r=0.516,P<0.05),and bone metastasis of PCa was positively correlated with PSA level(r=0.494,P<0.05).The prostate disease deterioration was positively correlated with the FPSA level(r=0.442,P<0.05),and the bone metastasis of PCa was positively correlated with FPSA level(r=0.438,P<0.05).And there was no statistical correlation between FPSA/PSA and prostate disease deterioration(r=-0.108,P>0.05).Conclusion The levels of PSAand FPSA are positively correlated with bone metastasis of prostate cancer.The decrease of FPSA/PSA is of diagnostic significance for malignant transformation of prostate.The combined detection of PSA,FPSA and FPSA/PSA has important reference value for the diagnosis of bone metastasis of prostate cancer.
引文
[1] 陈勇杰,许春.血清骨膜素联合PSA检测对前列腺癌的诊断价值分析[J].国际泌尿系统杂志2018,38(3):375-379.
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[4] Watt KW,Lee PJ,M'Timkulu T,et al.Human prostate-specific antigen:structural and functional similarity with serine proteases[J].Proc Natl Acad Sci U S A,1986,83(10):3166-3170.
[5] 孙敏,徐永成,田军.利用ROC曲线确定PSA诊断女性乳腺癌最佳临界值[J].标记免疫分析与临床,2016,23(11):1303-1305.
[6] 江绍钦,李梦强,许恩赐,等.前列腺癌内分泌治疗后进展为去势抵抗性前列腺癌的危险因素分析[J].中华泌尿外科杂志,2018,39(11):847-851.
[7] 郑岗,关晏星.PSA、fPSA/PSA与前列腺癌骨转移的关系[J].江西医学院学报,2008,48(2):85-86.
[8] 毕泗成,刘浩,张鹏,等.血清LCN2与PSA联合检测对前列腺癌的诊断价值[J].国际肿瘤学杂志,2018,45(1):37-41.
[9] 郑丹,孙艳虹,吴娟.血清 t-PSA、f-PSA、f-PSA/t-PSA及铁蛋白检测在前列腺癌诊断中的意义[J].实验与检验医学,2018,36(4):578-581.
[2] 石洪成.SPECT/诊断CT操作规范与临床应用[M].上海:上海科学技术出版社,2015:63-65.
[3] 蒋炳辰,张雪辉,高永旺,等.放射性核素骨显像联合血清CA153、CA50、IL-8评价乳腺癌骨转移的临床意义[J].右江医学,2013,41(2):189-191.
[4] Watt KW,Lee PJ,M'Timkulu T,et al.Human prostate-specific antigen:structural and functional similarity with serine proteases[J].Proc Natl Acad Sci U S A,1986,83(10):3166-3170.
[5] 孙敏,徐永成,田军.利用ROC曲线确定PSA诊断女性乳腺癌最佳临界值[J].标记免疫分析与临床,2016,23(11):1303-1305.
[6] 江绍钦,李梦强,许恩赐,等.前列腺癌内分泌治疗后进展为去势抵抗性前列腺癌的危险因素分析[J].中华泌尿外科杂志,2018,39(11):847-851.
[7] 郑岗,关晏星.PSA、fPSA/PSA与前列腺癌骨转移的关系[J].江西医学院学报,2008,48(2):85-86.
[8] 毕泗成,刘浩,张鹏,等.血清LCN2与PSA联合检测对前列腺癌的诊断价值[J].国际肿瘤学杂志,2018,45(1):37-41.
[9] 郑丹,孙艳虹,吴娟.血清 t-PSA、f-PSA、f-PSA/t-PSA及铁蛋白检测在前列腺癌诊断中的意义[J].实验与检验医学,2018,36(4):578-581.