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目的探讨血清性激素在前列腺癌(PCa)诊断中的作用价值及与前列腺特异性抗原(PSA)的关系。方法 PCa患者30例、良性前列腺增生症(BPH)患者45例及正常人45例,检测睾酮(T)、雌二醇(E2)、孕酮(P)、卵泡刺激素(FSH)、黄体生成素(LH)及泌乳素(PRL)和PSA的水平。比较各组间性激素及PSA的差异。分析性激素及PSA对PCa的诊断价值及两者的相关性。结果 PCa组中T降低明显,FSH、LH增高明显;总PSA(tPSA)、游离PSA(fPSA)、PSA密度(PSAD)增高明显,fPSA与tPSA比值(f/tPSA)降低明显。tPSA、fPSA、PSAD、T、FSH、LH的ROC曲线下面积(AROC)分别为1.000、0.894、0.991、0.920、0.753、0.868;各检测参数AROC比较,tPSA和PSAD、fPSA和T、fPSA和LH、PSAD和T、T和LH、FSH和LH配对比较差异无统计学意义(P>0.05),余配对比较差异有统计学意义(P<0.05)。相关性分析结果显示,PCa患者tPSA与T有相关性(P<0.05),与E2、P、FSH、LH及PRL水平无相关性(P>0.05)。结论 PCa患者T水平降低,FSH、LH水平增高。PCa患者PSA与血清T有相关性,T、FSH和LH对早期PCa具有与tPSA、f/tPSA和PSAD接近相同的诊断能力。血清PSA联合性激素T、FSH和LH检测有助于PCa的早期诊断。
Objective To investigate the value of serum sex hormones in the diagnosis of prostate cancer (PCa) and its relationship with prostate-specific antigen (PSA). Methods Thirty patients with PCa, 45 patients with benign prostatic hyperplasia (BPH) and 45 normal controls were enrolled in this study. Testosterone (T), estradiol (E2), progesterone (P), follicle stimulating hormone (FSH) (LH) and prolactin (PRL) and PSA levels. The differences of sex hormones and PSA between the groups were compared. To analyze the diagnostic value of sex hormones and PSA to PCa and their correlation. Results The level of T decreased significantly in PCa group, and the levels of FSH and LH increased significantly. The total PSA (tPSA), free PSA (fPSA) and PSA density (PSAD) increased significantly and the ratio of fPSA to tPSA decreased obviously. The area under the ROC curve (AROC) of tPSA, fPSA, PSAD, T, FSH and LH were 1.000,0.894,0.991,0.920,0.753,0.868 respectively. The AROC, tPSA and PSAD, fPSA and T, fPSA and LH There was no significant difference in the pairing between PSAD and T, T and LH, FSH and LH (P> 0.05). There was significant difference between the two groups (P <0.05). Correlation analysis showed that there was no significant correlation between tPSA and T (P <0.05) and E2, P, FSH, LH and PRL in patients with PCa (P> 0.05). Conclusion The level of T in PCa patients decreased and the levels of FSH and LH increased. PSA in patients with PCa and serum T has a correlation, T, FSH and LH early PCa with tPSA, f / tPSA and PSAD close to the same diagnostic ability. Serum PSA combined with sex hormones T, FSH and LH detection contribute to the early diagnosis of PCa.