[1]张 伟,凌 芸,宋为娟,等.南京地区表观健康人群前列腺特异性抗原的参考值区间建立[J].现代检验医学杂志,2017,32(02):53-56.[doi:10.3969/j.issn.1671-7414.2017.02.014]
　ZHANG Wei,LING Yun,SONG Wei-juan,et al.Establishment of Reference Interval for Serum Prostate-Specific Antigen(PSA)of Apparent Healthy Men in Nanjing[J].Journal of Modern Laboratory Medicine,2017,32(02):53-56.[doi:10.3969/j.issn.1671-7414.2017.02.014]
点击复制

南京地区表观健康人群前列腺特异性抗原的参考值区间建立()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年02期
页码:
53-56
栏目:
论著
出版日期:
2017-03-25

文章信息/Info

Title:
Establishment of Reference Interval for Serum Prostate-Specific Antigen(PSA)of Apparent Healthy Men in Nanjing
文章编号:
1671-7414(2017)02-053-04
作者:
张 伟,凌 芸,宋为娟,杨瑞霞,徐华国,谢而付
南京医科大学第一附属医院检验学部,南京 210029
Author(s):
ZHANG Wei,LING Yun,SONG Wei-juan,YANG Rui-xia,XUHua-guo,XIE Er-fu
Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
关键词:
不同年龄段;  前列腺特异性抗原;  参考值区间
分类号:
R446.6
DOI:
10.3969/j.issn.1671-7414.2017.02.014
文献标志码:
A
摘要:
目的 建立南京地区不同年龄段、表观健康人群前列腺特异性抗原(prostate-specific antigen,PSA)的参考值区间。方法 选取2013年10月～2015年9月在南京医科大学第一附属医院进行体检的25 820例健康男性作为观察人群,受检者均经前列腺B超的筛查,排除下尿路异常疾病。采用全自动发光免疫分析仪检测血清中PSA浓度及游离前列腺特异性抗原(free prostate-specific antigen,fPSA)浓度,并计算fPSA/PSA比值。将受检者按年龄分为四组(20～39岁,40～59岁,60～79岁以及80岁以上),分别统计PSA及fPSA/PSA的中位数,5%分位数,25%分位数,75%分位数和95%分位数。结果 25 820例男性按年龄由低到高各组PSA中位数(95%分位数)分别为:0.78(1.93),0.90(2.93),1.34(6.60)和2.01(11.91); 25%分位数至75%分位数分别为0. 55～1.11,0.61～1.36,0.77～2.51和0.94～4.19。fPSA/PSA中位数(95%分位数)分别为:0.37(0.60),0.31(0.56),0.28(0.53)和0.29(0.52); 25%分位数至75%分位数分别为0.28～0.46,0.23～0.40,0.22～0.36和0.23～0.37。各年龄组间PSA及fPSA/PSA中位数差异均有统计学意义(P值均<0.05),其中PSA水平随着年龄增长呈上升趋势。不同地区的PSA研究结果也有所不同。结论 南京地区40岁以下男性PSA应以0～2.5 ng/ml作为参考值区间,40～60岁男性以0～4 ng/ml作为参考值区间,60岁以上以0～5 ng/ml作为参考值区间。
Abstract:
Objective To establish the reference interval for serum prostate-specific antigen(PSA)in apparent healthy men of different ages in Nanjing.Methods A total of 25 820 healthy men undergoing routine physical examinations in the First Affiliated Hospital of Nanjing Medical University from October 2013 to September 2015 were selected for thestudy. All of them were screened by prostate B ultrasound,excluding abnormal urinary tract diseases.The concentration of serum PSA and free prostate-specific antigen(fPSA)were measured by automatic luminescence immunoassay analyzer,and the fPSA/PSA values were calculated.The participants were divided into fourgroups(20～39,40～59,60～79 and older than 80 years old groups),then the median,5th,25th,75th and 95th percentiles of both PSA and fPSA/PSA were counted,respectively.Results The median of PSA(95th percentile ranges)of these groups by age from low to high were 0.78(1.93),0.90(2.93),1.34(6.60)and 2.01(11.91),respectively.The 25th to 75th percentiles were0.55～1.11,0.61～1.36,0.77～2.51 and 0.94～4.19,respectively.The medianof fPSA/PSA(95th percentile ranges)were 0.37(0.60),0.31(0.56),0.28(0.53)and 0.29(0.52),respectively.The 25th to 75th percentiles were 0.28～0.46,0.23～0.40,0.22～0.36 and 0.23～0.37,respectively.Among all the groups,median differences of both PSA and fPSA/PSA were statistically significant(P<0.05),and PSA levels rise with age.PSA levels in different regions were different.Conclusion The PSA level of men under 40 years in Nanjing should be 0～2.5 ng/ml,40～60 years should be 0～4 ng/ml,while men whoare above 60 years,could use 0～5 ng/ml as reference interval.

参考文献/References:

[1] Balk SP,Ko YJ,Bubley GJ.Biology of prostate-specific antigen[J].Journal of Clinical Oncology,2003,21(2):383-391.
[2] Thompson IM,Ankerst DP.Prostate-specific antigen in the early detection of prostate cancer[J].Canadian Medical Association Journal,2007,176(13):1853-1858.
[3] Lilja H.Biology of prostate-specific antigen[J].Urology,2003,62(1):27-33.
[4] Loeb S,Roehl KA,Catalona WJ,et al.Prostate specific antigen velocitythreshold for predicting prostate cancer in young men[J].Journal of Urology,2007,177(3):899-902.
[5] 马明辉,黄庆波,高 宇,等.f/t PSA,PSAD,(f/t)/PSAD在PSA 4～20μg/L区间对前列腺癌的诊断预测价值[J].微创泌尿外科杂志,2015,4(6):366-371. Ma MH,Huang QB,Gao Y,et al.Predicted value of free-to-total prostate specific antigen(f/t PSA),prostate specific antigen density(PSAD)and(f/t)/PSAD in the diagnosis of prostate cancer with PSA between 4 and 20 μg/L[J].Journal of Minimally Invasive Urology,2015,4(6):366-371.
[6] 周 刚,彭境罗,刘幸生,等.f/t PSA与PSAD对tPSA灰区且直肠指检阴性前列腺癌诊断价值的Meta分析[J].循证医学,2015,15(1):48-53. Zhou G,Peng JL,Liu XS,et al.Diagnostic value of f/tPSA versus PSAD for tPSA gray zone prostate cancer with normal digital rectal examination:ameta-analysis[J].The Journal of Evidence-Based Medicine,2015,15(1):48-53.
[7] Mistry K,Cable G.Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma[J].Journal ofthe American Board of Family Practice,2003,16(2):95-101.
[8] Harvey P,Basuita A,Endersby D,et al.A systematic review of the diagnostic accuracy of prostate specific antigen[J].BMC Urology,2009(9):14.
[9] Oesterling JE,Jacobsen SJ,Chute CG,et al.Serum prostate-specific antigen in a community-based population of healthy men.Establishment of age-specific reference ranges[J].Journal of American Medical Association,1993,270(7):860-864.
[10] 毕红琳.按年龄分层设定PSA在前列腺癌诊断中的诊断界值的意义探讨[J].现代检验医学杂志,2011,26(1):90-91. Bi HL.Significance of setting the cutoff line of serum PSA for identification patients with prostate cancer[J].Journal of Modern Laboratory Medicine,2011,26(1):90-91.
[11] Yuan XD,Dong ZG,Zhang H,et al.Distribution of serum prostate-specific antigen in Chinese healthy men:a population-based study[J].Chinese Medical Journal,2011,124(8):1189-1192.
[12] 刘 欣,王 节,张舜欣,等.北京地区临床无前列腺癌人群年龄相关性前列腺特异性抗原的参考范围[J].南方医科大学学报,2013,33(11):1704-1708. Liu X,Wang J,Zhang SX,et al.Age-related reference range for serum prostate-specific antigen in men free of prostate cancer in Beijing[J].Journalof Southern Medical University,2013,33(11):1704-1708.
[13] Lin KJ,Pang ST,Chang YH,et al.Age-ralated reference levels of serumprostate-specific antigen amang Taiwanese men without clinical evidence of prostate cancer[J].Chang Gung Medical Journal,2010,33(2):182-187.
[14] He D,Wang M,Chen X,et al.Ethnic difference in distribution of serumprostate-specific antigen:a study in a healthy Chinese male population[J].Urolgy,2004,63(4):722-726.
[15] Liu ZY,Sun YH,Xu CL,et al.Age-specific PSA reference ranges in Chinese men without prostate cancer[J].Asian Journal of Andrology,2009,11(1):100-103.
[16] Partin AW,Oesterling JE.The clinical usefulness of prostate specific antigen: update 1994[J].Journal of Urology,1994,152(5 Pt 1):1358-1368.

备注/Memo

备注/Memo:
基金项目:江苏省实验诊断学重点实验室基金(XK201114); 江苏高校优势学科建设工程资助项目(JX10231802)。
作者简介:张 伟(1984-),女,大学本科,主管技师,从事医学检验工作,研究方向为肿瘤标志物的临床检测,Tel:18951889082,E-mail:zhang_wei@njmu.edu.cn。
通讯作者:谢而付,男,副主任技师,硕士,E-mail:13813011342@163.com。
更新日期/Last Update: 2017-04-10