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

Backgroud:since wang separated and purified prostate-specific antigen (PSA )from Prostate tissue in 1979, PSA is still an indispensable tumor mark for screening or diagnosing prostrate adenocarcinoma (PCa). And it is widely use. However, serum PSA do not have the disease-specific. Serum PSA may increase both in prostate tumor and non-tumor diseases. Thus high PSA only imply prostate disease but prostate cancer is not sure.The significant high PSA usually imply prostate cancer.But when PSA increase slightly it is difficult to identify whether it is benign prostatic hyperplasia or early stage prostate cancer.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.Objective:To investigate the serum levels of t-PSA,f-PSA,f /t-PSA,prostate volume(PV) and PSAD and find the significance to diagnosis and differential diagnosis of BPH and Pca.To recommend the best cut-off point of PSAD and F/T to do prostate biopsy or not and investigate the relationship between serum level of t-PSA and Gleason score.Objects and Methods:We collected about302 patients with BPH and 106patients with PCawho were in the affiliated union hospital of Fujian medical University from 2007-1 to 2009-1. 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 F/T,the PV and PSAD. Analyze the relationship between age and the data of t-PSA, f-PSA, PVin PCa and BPH group. Analyze the data of t-PSA, f-PSA,f/t-PSA and PSAD between the group of BPH and PCa. TO figure out the sensitivity and specificity when different PSAD and F / T value as a puncture standards of Prostate biopsy and investigate the relationship between serum level of t-PSA and Gleason score.Results:1. Serum t-PSA , f-PSA levels and pv of 302 patients with BPH increased with age and there were positive correlations(P< 0.01),But there were no correlation between serum t-PSA ,f-PSA levels and age of 204 patients with PCA.2. The levels of t-PSA,f-PSA and PSAD were high in the group of PCa(P<0.0 1).3. There is significant difference of t-PSA in the high-value area outside Gray area in two groups. But there is not significant difference in Gray area and the low-value area outside Gray area. There is significant difference of PSAD in Gray area and the high-value area outside Gray area.But there is not significant difference in the low-value area outside Gray area. There is significant difference of F/T in Gray area .But there is not significant difference in the low-value and high-value area outside Gray area.4 .When t-PSA was 4-10ng/lm ,PSAD≥0.15, F/T≤0.20 were recommended to do prostate biopsy. The sensitivity and specificity of PSAD was 75.0% and 53.0%. The sensitivity and specificity of F/T was 65.0% and 54.1%.5 .There are no Correlation between Gleason score With serum PSAConclusions: Serum 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 thus can reduce unnecessary prostate Biopsy.