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目的 :探讨前列腺癌患者血清前列腺特异抗原密度 (PSAD)与组织原位PSA表达的关系。方法 :参照Gleason标准对 2 5例前列腺腺癌组织进行分级 ,用免疫组织化学SP法检测前列腺癌组织中PSA ,术前 1周用化学发光分析法测定血清PSA浓度及经腹B超测定前列腺体积 ,二者之比为PSAD。结果 :5例高分化肿瘤全部呈强阳性 ;13例中分化肿瘤中 ,4例呈强阳性 ,9例呈弱阳性 ;7例低分化肿瘤中 ,1例呈强阳性 ,3例呈弱阳性 ,3例阴性。 2 5例腺癌PSAD为 0 .36～ 1.5 3(U =0 .75 )。不同分化的癌组织的PSA表达强度差异有显著性意义(P <0 .0 5 ) ,高、中分化组的血PSAD与低分化组差异有显著性意义 (P <0 .0 5 ) ,不同PSA表达强度的患者血PSAD差异无显著性意义 (P >0 .0 5 )。结论 :癌组织中蛋白酶的破坏造成PSA漏出增多 ,可能与血PSAD升高有关。癌组织PSA的免疫组织化学反应强度不能用于解释血PSAD的变化
Objective: To investigate the relationship between serum prostate specific antigen density (PSAD) and tissue in situ PSA expression in patients with prostate cancer. Methods: 25 cases of prostatic adenocarcinoma were graded according to the Gleason criteria. PSA in prostate cancer tissues was detected by immunohistochemical SP method. Serum PSA concentration was measured by chemiluminescence assay and the prostate volume , The ratio between the two is PSAD. Results: Among 5 cases of well differentiated tumors, all of them were strongly positive. Among the 13 cases of moderately differentiated tumors, 4 were strongly positive and 9 were weakly positive. Among the 7 poorly differentiated tumors, 1 was strongly positive and 3 was weakly positive, 3 cases were negative. PSAD of 25 cases of adenocarcinoma ranged from 0.36 to 1.53 (U = 0.75). There was a significant difference in the PSA expression intensity between different differentiated cancers (P <0.05). There was a significant difference between PSAD and poorly differentiated groups in high and moderately differentiated cancers (P <0.05) There was no significant difference in PSAD among patients with PSA expression intensity (P> 0.05). Conclusion: The destruction of protease in cancer tissue leads to the increase of PSA leakage, which may be related to the increase of blood PSAD. The intensity of the immunohistochemistry of the cancerous tissue PSA can not be used to explain changes in the blood PSAD