北京大学学报(医学版)同族
・234・
JOURNAL OF PEKING UNIVERSITY!HEALTH SCIENCES)Vol.52Na.2Apr.2020
-著-前列腺特异性抗原同源异构体2及其衍生指标在
预测前列腺癌病理分级中的价值
孙奎霞，闫存玲△，李志艳，刘平，张伟，何群
!北京大学第一医院检验科，北京100034)
convention［摘要］目的：探讨血清前列腺特异性抗原同源异构体2(isoform［--propestate-specific antigen,p2PSA)及经计
算得到的%p2PSA和前列腺健康指数(prostate health index,PHI)等指标预测前列腺癌(prostate cancer,PCa)病理分
级的价值。方法：回顾性入组了322例来自北京大学第一医院在2015年8月至2018年5月期间就诊的PCa校准英文
患者，
potions
其中143例为进行经直肠超声引导的前列腺穿刺活检证实的PCa患者,179例为进行PCa根治术的患者。采用全satisfaction怎么读
自动免疫分析仪DxNOO检测患者的术前预留血清中前列腺特异性抗原(total prostate-specific antigen,tNSA)(游离
前列腺抗原！fee prostate antigen,fOSA)、fOSA/tPSA比值(Bt)、p2PSA水平，并计算得到％p2PSA和PHI，以术后病
yingyu
理结果确定Gleason评分，采用受试者工作曲线！eceivsr operating characWris/o curve,ROC)比较p2PSA、％p2PSA及
PHI与传统指标tPSA、fOSA和f/t预测高级别前列腺癌！Gleason评分$7)的价值。结果:Gleason评分$7患者的
p2PSA、％p2PSA和PHI的中位数水平均高于Gleason评分<7患者(p2PSA：30.22“///*.18.33ny/L；%p2PSA：
ysm
2.50*1-7；PHI：91.81*35.44；P值均<0.01)°%p2PSA和PHI预测高级别PCa的曲线下面积！area under
curve,AUC)为0.770和0.760，高于传统指标tPSA、/SA和f/t(AUC分别为0.648,0.536和0.693)。进行前列腺
穿刺术证实为PCa的患者中，PHI和％p2PSA预测高级别PCa的价值！AUC分别为0.801和0.808)明显高于tPSA、
fPSA和f/t(AUC分别为0.729,0.655和0.665)。进行PCa根治术后的患者中,PHI和％p2PSA预测高级别PCa的
上海洋泾中学
价值(AUC分别为0-98和0.744)也有高于其他传统指标tPSA、PSA和Pt(AUC分别为0.625,0.507和0.697)
的趋势。结论：与传统指标tPSA、PSA和f/t相比,p2PSA的衍生指标％p2PSA和PHI对于高级别PCa具有更高的
预测价值，可以帮助临床评估PCa治疗方案，为患者及时制定更合适的诊疗策略。
［关键词］前列腺特异性抗原同源异构体2；前列腺健康指数；前列腺癌
［中图分类号］R737.2［文献标志码］A［文章编号］1671-167X(2020)02-0234-06
doi：10.19723/j.issn.1671-167X.2020-2-07
山市译文
Clinical value of rum isoform-2proprostate-specinc antigee and its derivatives
in predicting aggressive prostate cancer
SUN Kui-iv,YAN Cun-Png!,LI Zhi-an,LIN Ping,ZHANG Wei,HE Qun
(Department of Clinical Laboetoe,Peking University First Hospital,Beijing100034,China)
ABSTRACT Objective:Ta explore the clinical vlue of em isofoni［--propestatv-specific antigen
(p2PSA)and its de ei eati ees%p2PSA and peostateh e aath indey(PHI)in peediting a ggee si eepeostate
cancer(PCa)-Methods：The pe-operation rum and'dsic clinmal data of322patients with PCa(in
cluding143patients diaanod with PCa'y transrectal ultrasound-auided prostate'Ppsy and179patients undergoing radical prostatectomy)in Peking University First Hospital were collected
Pom August2015to
May2018.S eum oa peosae-speeieie n gen(PSA),e peos>ean gen(ePSA)nd ePSA/PSA
aloof
(Pt)and th e p2PSA level of all the patients were measured on automat i c immune analyzers DxI800,
and t hen%p2PSA and PHIweee aaeua a ed.Th peost a epath o aogi esuatw onsid eed a s thegoad standaed to eaauatetheGaeason s e o eeoe t hep ti e ntswih PCa.Re e e ieeop e a toeeuee e s(ROC)weee
ud to asss the a'i/ty of p2PSA,%p2PSA and PHI to predict aggressive PCa(patholovic Gleason
score$7)compared with tho traditional markers tPSA,PSA and Pt.Resilts:Among the patients,
the p2PSA,%p2PSA and PHI median levels wer e significantly higher in patients with patholovic Gleason
score$7than tho with Gleason score<7(p2PSA:30.22ng//*-18.33ng/L；%p2PSA：2.50*-
1.27;PHI:91.81*-35.44；f P<0.01)-The area under cuee(AUC)of%p2PSA and PHI
(0.770,0.760)in predicting Gleason score$7were higher than tho of the traditional indicators
tPSA,PSA and Pt(AUC were0.648,0.536and0.693,respectively)-Among tho patients diaa
nod with PCa'y transrectal ultrasound-auided prostate'Ppsy,the AUC of%p2PSA and PHI(AUC
were0-808and0.801,respectively)in predicting Gleason score$7were higher than tho of the Wadi-
△Coeespocdicy author&s c-mail,『玄“—“/弐®
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