目的 比较在血清前列腺特异性抗原(PSA)灰区游离与总量比值 (fPSA/tPSA)、PSA密度(PSAD)、PSA移行带密度(PSATZ)对前列腺癌的诊断价值。方法 选取tPSA在4～10 μg/L的前列腺癌(PCa)和良性前列腺增生(BPH)患者共173例,测其血中tPSA和fPSA,计算fPSA/tPSA比值;经直肠B超测前列腺体积,计算PSAD、PSATZ。用Python 3.5软件分析fPSA/tPSA,PSAD,PSATZ在PSA灰区对PCa的诊断价值。结果 PCa组 和 BPH组血清fPSA/tPSA分别为 0.17±0.072、0.2±0.085;PSAD分别为(0.25±0.11) μg/L、(0.14±0.054) μg/L;PSATZ分别为 (0.53±0.31) μg/L、(0.25±0.14) μg/L;两组在以上三个检测指标上差异具有统计学意义 (P<0.05)。fPSA/tPSA与PSAD对腺癌的敏感度达79%。结论 在PSA灰区,PSAD,PSATZ均能提高PCa诊断的敏感性,且fPSA/tPSA、PSAD、 PSATZ对于PCa的诊断具有重要价值。

Objective To explore the diagnostic significance of ratio of free prostate specific antigen to total prostate (fPSA/tPSA), prostate specific antigen density (PSAD), and prostate specific antigen transition zone density (PSATZ) in serum prostate specific antigen (PSA) gray area for prostate cancer (PCa).Methods A total of 173 cases with PCa and benign prostatic hyperplasia (BPH) whose tPSA levels were 4-10 ng/mL were selected in the study. Serum fPSA and tPSA were detected, and fPSA/tPSA ratio was calculated. Prostate volume was determined by transtectal ultrasound. PSAD and PSATZ were calculated.The diagnostic significance of fPSA/tPSA, PSAD, and PSATZ in PSA gray area for PCa were analyzed using Python 3.5 software.Results The PCa patients’ and the BPH patients’ fPSA/tPSA ratios were 0.17±0.072 and 0.2±0.085 respectively.Their PSADs were (0.25±0.11) μg/L and (0.14±0.054) μg/L respectively. Their PSADTZs were (0.53±0.31) μg/L and (0.25±0.14) μg/L respectively. The two groups showed significant differences in the above three indicators (P<0.05). The sensitivity of fPSA/tPSA and PSAD for PCa reached 79%.Conclusion Both PSAD and PSATZ in PSA gray area can increase sensitivity in the diagnosis of PCa. Moreover, fPSA/tPSA, PSAD, and PSADTZ are of great value for the diagnosis of PCa.