Research On PSA Related Variables In Prostate Cancer Diagnosis In Patients With Grey Zone Of PSA

Objective:To investigate the diagnostic value of F/TPSA, and PSAD for prostate cancer patients while TPSA was at 4~10 ng/ml. Methods:Clinical data of serum TPSA in range of 4~10ng/ml from 89 patients during March 2013 to December 2014 were analyzed who accepted the diagnosis and treatment in Affiliated Hospital of Qinghai University and Qinghai People’s Hospital. From the results for the pathological diagnosis, 17 cases were prostate cancer while 72 cases were benign prostatic hyperplasia. TPSA and FPSA were detected respectively by enzyme-linked immunosorbent assay(ELISA) and the ratio of F/TPSA was calculated. Anteroposterior, left-right and supra-inferior diameters were measured by B-ultrasound and then prostate biopsy examinations by transrectal ultrasound or operative treatment were conducted for all patients. The diagnostic value of F/TPSA and PSAD were evaluated for patients of prostate cancer by using an independent t test and the receiver operating characteristic curve(ROC curve) when the serum TPSA was at 4~10 ng/ml. Results:1. F/TPSA ratio in BPH group was significantly higher than that in PCa group(P<0.05), while PSAD in BPH group was lower than that in prostate cancer group(P<0.05). 2. When compared the area of F/TPSA and PSAD under ROC curve, the descending order was PSAD>F/TPSA. When F/TPSA=0.16, the sensitivity for the diagnosis of PCa was 52.90% and the specificity was 94.40%. When PSAD =0.17, the sensitivity for the diagnosis of PCa was 64.70% and the specificity was 84.70%. Conclusions:1. This study suggests that when TPSA is at 4~10 ng/ml, F/TPSA and PSAD can help prostate specific antigen for improving the accuracy of the clinical diagnosis of PCa. The diagnostic effect of PCa for PSAD is better than F/TPSA. Therefore, PSAD can serve as an important indicator of the clinical diagnosis of PCa. 2. This study suggest that the better optimal cutoff point of F/TPSA is 0.16 and PSAD is 0.17.