天津医药

• 循证医学 •    

f/tPSA与PSAD对总PSA灰区前列腺癌诊断价值的Meta分析

党瑞锋1,徐勇2,张志宏1,李双辉1   

  1. 1. 天津医科大学第二医院泌尿外科
    2. 天津医科大学第二医院
  • 收稿日期:2011-05-23 修回日期:2011-09-12 出版日期:2012-03-15 发布日期:2012-03-15
  • 通讯作者: 党瑞锋

Diagnostic Value of f/tPSA versus PSAD for TPSA Gray Zone Prostate Cancer：A Meta — analysis

  • Received:2011-05-23 Revised:2011-09-12 Published:2012-03-15 Online:2012-03-15

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摘要： 目的：系统评价总PSA处于4～10ng/ml时，游离PSA／总PSA与前列腺特异抗原密度对前列腺癌的诊断价值。方法：利用计算机检索Cochrane图书馆、PubMed、中国生物医学文献数据库等，收集有关f/t PSA 和PSAD比较诊断前列腺癌的文献，采用QUADAS进行质量评价，用 MetaDisc1.4软件进行Meta分析。结果：共纳入7篇文献，共1013例。f/tPSA 和PSAD诊断前列腺癌的敏感度及特异度分别为0.78、0.54和0.79、0.57，两者的综合受试者工作特征曲线下面积分别为0.7761和0.7821，Q指数分别为0.7153和0.7204。结论：总PSA处于4-10ng/ml时，f/t PSA与PSAD之间的敏感性和特异性无明显差别，对前列腺癌的诊断效能无明显差异，二者对于总PSA灰区前列腺癌的诊断均有重要的临床价值。

关键词: 前列腺癌, 前列腺特异性抗原, 诊断, Meta分析

Abstract: Objective：To systematically assess the diagnostic value of f/t PSA and PSAD for prostate cancer in patients with tPSA level of 4-l0 ng/ml. Method：We retrieved the studies about f/t PSA and PSAD in the diagnosis of prostate cancer from the databases of Cochrane library，PubMed，Chinese Biomedical Literature Database，and so on. Quality of included trials was assessed according to QUADAS items. The software MetaDisc1.4 was used for data analysis. Result：A tota1 of 7 researches involving 1013 patients were included. Respectively, the pooled accuracy indicators of sensitivity, specificity of f/tPSA and PSAD were 0.78,0.54and 0.79,0.57.the area under curve of SROC curve of f/tPSA and PSAD were 0.7761 and 0.7821,Q index were 0.7153 and 0.7204．Conclusion：When the tPSA is 4-10ng/ml, f/t PSA and PSAD for prostate cancer diagnosis was no significant difference, both for the diagnosis of prostate cancer has important clinical value.

Key words: prostate cancer, prostate-specific antigen, diagnosis, meta analysis