前列腺癌术前常用肿瘤标志物的临床应用价值分析
Analysis of the Clinical Application Value of Commonly Used Tumour Markers before Prostate Cancer
摘要: 前列腺癌(Prostate Cancer, PCa)是严重威胁男性健康的常见恶性肿瘤，早期诊断对改善预后至关重要。虽然前列腺穿刺活检是诊断金标准，但其有创性限制了临床应用。血清学肿瘤标志物检测因其无创、便捷等优势，在前列腺癌筛查和诊断中扮演重要角色。然而，当血清总前列腺特异性抗原(Total Prostate Specific Antigen, tPSA)处于4~10 ng/mL的“诊断灰区”时，其诊断价值有限。本文基于国内外相关文献，系统综述了前列腺特异性抗原(PSA)、游离PSA (fPSA)及其比值(fPSA/tPSA)、前列腺特异性抗原密度(PSAD)、PSA速率(PSAV)、尿液标志物(PCA3)以及前列腺健康指数(PHI)等常用术前肿瘤标志物的临床应用价值，探讨其在辅助诊断、危险分层、指导治疗决策及预测预后中的作用，分析现有标志物的局限性，并展望新型标志物的研究进展与未来趋势，旨在为前列腺癌的精准诊疗提供参考依据。
Abstract: Prostate cancer (PCa) is a common malignant tumour that seriously threatens men’s health, and early diagnosis is crucial to improve prognosis. Although prostate biopsy is the gold standard in diagnosis, its invasiveness limits clinical application. Serological tumour marker testing plays an important role in prostate cancer screening and diagnosis due to its advantages such as non-invasiveness and convenience. However, when serum Total Prostate Specific Antigen (tPSA) is in the “diagnostic grey zone” of 4~10 ng/mL, its diagnostic value is limited. Based on relevant literature at home and abroad, this paper systematically reviews the clinical application value of commonly used preoperative tumour markers such as prostate-specific antigen (PSA), free PSA (fPSA) and their ratios (fPSA/tPSA), prostate-specific antigen density (PSAD), PSA rate (PSAV), urine markers (PCA3), and prostate health index (PHI), and explores their role in auxiliary diagnosis, risk stratification, guiding treatment decisions and predicting prognosis. The limitations of existing markers are analysed, and the research progress and future trends of new markers are prospected, aiming to provide a reference for the precise diagnosis and treatment of prostate cancer.
文章引用：孙靖奇, 徐鸿洁. 前列腺癌术前常用肿瘤标志物的临床应用价值分析[J]. 临床医学进展, 2025, 15(9): 1-9. https://doi.org/10.12677/acm.2025.1592449

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