前立腺癌腫瘍マーカーとしての前立腺特異抗原・前立腺性酸性ホスファターゼの検討 : ラテックス免疫比濁法による検討

Abstract

LPIAエースPSAとMARKITT-F-PA, LPIAエースPSAとTANDEM-E PSA, LPIAエースPAPとABBOTT-PAP EIA(酵素免疫定量)との間には高い線形相関があった.良性前立腺肥大症患者を陰性対照とすると, PSA(前立腺特異抗原)のカットオフ値は4.3ng/mlで, これを用いると感度, 特異度及び効率はそれぞれ78, 95, 及び89%であった.臨床進行時, 前立腺癌のPSA値は68%でカットオフ値以上に上昇していた.LPIAエースPAPによるPAP(前立腺性酸性ホスファターゼ)のカットオフ値は9.0ng/mlで, 感度, 特異度及び効率はそれぞれ39, 96, 及び77%であった

Serum prostate specific antigen (PSA) and prostatic acid-phosphatase (PAP) levels in normal controls, and patients with prostate cancer, benign prostate hypertrophy (BPH) and other urological diseases were examined with a newly developed latex turbidimetric immunoassay (LPIA ACE PSA, LPIA ACE PAP, IATRON LABORATORIES, INC., Tokyo, Japan). The advantageous characteristics of this method are small amount (10 microliters) of serum required and short time (about 20 min.) for performing this assay. There was a high linear correlation between LPIA ACE PSA and MARKIT-F PA (r2 = 0.953), between LPIA ACE PSA and TANDEM-E PSA (r2 = 0.881) and between LPIA ACE PAP and ABBOTT-PAP EIA (r2 = 0.946). When the BPH patients (n = 110) were used as negative controls, the cut-off value of PSA was determined to be 4.3 ng/ml. Using this level as the cut-off value, the sensitivity was 78% (42 positive/54 untreated prostate cancer patients), specificity (negative rate in BPH patients) was 95% and efficiency was 89%. In a follow-up study of prostate cancer, the PSA value was elevated above the cut-off value in 68% at the time of clinical progression. These findings suggest that LPIA ACE PSA is a useful tool for serum PSA measurement. The cut-off value of PAP measured with LPIA ACE PAP was 9.0 ng/ml, which was determined by the same method as PSA. The sensitivity, specificity and efficiency ware 39%, 96% and 77%, respectively. These findings indicate that PAP is less useful than PSA in the diagnosis of prostate cancer.(ABSTRACT TRUNCATED AT 250 WORDS)