摘要目的 探讨移行带前列腺特异性抗原密度(TZPSAD)在前列腺特异性抗原(PSA)4.0～10.0 μg/L 和 10.1～20.0 μg/L时诊断前列腺癌的意义.方法 回顾性分析1999年11月至2009年8月在本院行前列腺穿刺活检的患者资料,以PSA 4.0～20.0 μg/L且有经直肠B超测量前列腺移行带资料的1 89例患者为研究对象,用接受者操作特性(ROC)曲线计算评估PSA和TZPSAD诊断前列腺癌的意义.分析PSA和TZ PSAD不同临界点在PSA 4.0～10.0 μg/L和10.1～20.0 μg/L范围内对前列腺癌的诊断效力.结果 40例(21.2％)诊断为前列腺癌,PSA 4.0～10.0μ/L时前列腺癌的阳性率为20.5％(16/78),PSA 10.1～20.0 μg/L时前列腺癌的阳性率为21.6％(24/111),两者差异无统计学意义(P=0.854).PSA4.0～10.0 μg/L时,PSA和TZPSAD预测前列腺癌ROC曲线下面积(AUC)分别为0.569和0.702;PSA10.1～20.0 μgL时,PSA和TZ PSAD预测前列腺癌AUC分别为0.463和0.730.TZPSAD 0.370和0.500 ng·ml-1·ml-1分别在PSA4.0～10.0和10.1～20.0 μg/L的诊断效力最大,其敏感性分别为68.8％和70.8％,特异性分别为72.6％和70.1％,结论 TZPSAD在PSA 4.0～ 10.0和10.1～20.0μg/L时诊断前列腺癌的效力均明显优于PSA,可明显提高PSA诊断前列腺癌的阳性率,减少不必要的前列腺穿刺活检.

abstractsObjective To determine the role of transition zone prostate-specific antigen density (TZPSAD) in the diagnosis of prostate cancer with prostate-specific antigen ( PSA ) in the ranges of 4.0-10.0 μg/L and 10.1-20.0 μg/L respectively.Methods A retrospective analysis was performed on the pofiles of patients who underwent prostate needle biopsy in Pengpai Memory Hospital of Haifeng between November 1999 and August 2009.The 189 subjects having the records of trans-rectal ultrasound transition zone measurement and PSA of 4.0- 20.0 μg/L were enrolled in the study.Receiver opcratmg characteristic curve was employed to assess the significance of PSA and TZPSAD in the diagnosis of prostate cancer.The diagnostic yield of different cut-off values of PSA and TZPSAD with the PSA of 4.0-10.0 μg/L and 10.1-20.0 μgL was evaluated respectively.Results Forty subjects (21.2％) were diagnosed as prostate cancer.There was no statistical difference (P=0.854) in the positive rate in those with PSA in the ranges of 4.0-10.0 μgL (20.5％,16/78 ) and 10.1-20.0 μg/L (21.6％,24/111 ).The area under cu-ve for PSA and TZPSAD was 0.569 and 0.702 in those having PSA of 4.0-10.0 μg/L,and this figure was 0.463 and 0.730 in subjects with PSA in the range of 10.1～20.0 μg/L accordingly.The best cut-off point of 0.370 ng· ml-1· ml- 1 and 0.500 ng· ml-1· ml-1 for TZPSAD corresponded to the PSA in the ranges of 4.0-10.0 μg/L (sensitivity:68.8％,specificity:72.6％ ) and 10.1-20.0 μg/L (sensitivity:70.8％,specificity:70.1％ ) respectively.Conclusion Featured of higher diagnostic yield with PSA of 4.0-10.0 μg/L and 10.1-20.0 μg/L,TZPSAD may therefore markedly improve the positive rate and reduce the need for prostate biopsy.