전립선비대증과 전립선암의 감별진단에 있어서 Free / Total PSA의 역할
The Role of Free/Total PSA in the Differential Diagnosis of the Prostate Cancer and Benign Prostatic Hyperplasia
홍범식, 안한종, 류진숙,
소속 상세정보
홍범식 ( )
울산대학교 의과대학 서울중앙병원
안한종 ( )
울산대학교 의과대학 서울중앙병원
류진숙 ( )
울산대학교 의과대학 서울중앙병원
KMID : 0358319970380121311
Abstract
결론
전립선암과 전립선비대증의 감별진단에 있어서 총 PSA의 cut-off value 6.0 ng/㎖과 비교
할 때 free/total PSA cut-off value를 0.20으로 하면 진단의 민감도는 93%로 유지하면서 특
이도를 32%에서 52%로 20% 향상시킬 수 있다. 특히 수신자 판단곡선에서 보여주듯이
PSA가 4.0 ng/㎖에서 10.0 ng/㎖사이의 환자에 있어서 free/total uSA는 총 PSA에 비해 보
다 신뢰도가 높은 검사라고 판단된다.
#초록#
Objectives: This study examined the role of free/total prostate specific antigen (PSA)
in the differentiation between prostate cancer and benign prostatic hyperplasia (BPH) in
patients with total PSA higher than 4.0 ng/㎖
Materials and Methods: Fourteen untreated patients with prostate cancer and 63
patients with BPH were included in this study All patients were pathologically
diagnosed by sextant transrectal biopsy before treatment. The level of total PSA and
free PSA were determined by immunoradiometric assay (Cis bio international). The
median values of total PSA and F/T (free/total PSA) were compared between prostate
cancer and BPH in the three different ranges of total PSA (PSA>4.0 ng/㎖, 4.0 ng/㎖
corves were obtained using sensitivity and specificity of total PSA and F/T at each
cutoff level.
Results: In the range of PSA between 4.0 and 10.0ng/㎖ , the median value of F/T
was significantly different between prostate cancer and BPH (p<0.05), while that of total
PSA was not. In other ranges of PSA, both total PSA and F/T were significantly
different between prostate cancer and BPH. The area under the F/T ROC curve was
significantly larger than that of total PSA ROC coNe only in the range of PSA between
4.0 and 10.0 ng/㎖. In the mean time, F/T was more specific than total PSA (52% vs
32%) at the identical sensitivity (93%) of F/T and total PSA cutoff values (F/T cutoff,
0.2; total PSA cutoff, 6.0 ng/㎖).
Conclusions: Free/Total PSA might provide us more reliable information on the
differential diagnosis of the prostate cancer, especially in patients with PSA range
between 4.0 and 10.0 ng/㎖.
키워드
PSA; Free PSA; Benign prostatic hyperplasia; Prostate cancer;
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