中文摘要：

目的：比较TuM2-PK,tPSA,fPSA/t PSA和PSAD在PSA灰区对前列腺癌的诊断价值。方法：选取tPSA在4～10 ng/mL的前列腺癌（PCa）、良性前列腺增生（BPH）及前列腺炎老年患者共252例,测其血中TuM2-PK,tPSA和fPSA,计算fPSA/tPSA比值;经直肠B超测前列腺体积,计算tPSA与前列腺体积之比,得到PSAD。用SPSS19.0分析TuM2-PK,tPSA,fPSA/tPSA和PSAD在PSA灰区对PCa的诊断价值。结果：PCa组的TuM2-PK,fPSA/tPSA和PSAD比前列腺炎老年组及BPH组均有显著变化（P〈0.05）;3组间的tPSA没有显著差异（P〉0.05）。TuM2-PK AUC（0.948）〉PSAD AUC（0.801）〉fPSA/tPSA AUC（0.610）〉tPSA AUC（0.499）。当TuM2-PK、tPSA、fPSA/tPSA和PSAD最佳临界值分别取24.30 U/mL、6.60 ng/mL、0.16和0.15 ng/（mL·cm3）时,诊断PCa的敏感性和特异性分别为88.9%和92.1%,72.2%和44.9%,80.5%和60.2%,83.3%和71.8%。结论：在PSA灰区,TuM2-PK、fPSA/tPSA、PSAD均能提高PCa诊断的敏感性和特异性,且TuM2-PK比fPSA/tPSA和PSAD对于PCa的诊断具有更高的准确性。

英文摘要：

Objective： To explore diagnostic significance of TuM2-PK, tPSA, fPSA/tPSA and PSAD for prostate cancer in PSA gray area.Methods： Two hundred and fifty-two cases with prostatic cancer（PCa）, benign prostatic hyperplasia（BPH） and prostatitis whose tPSA levels were between 4 ng/mL and 10 ng/mL were chosen. Plasmatic TuM2-PK and serum fPSA, tPSA were examined. Prostate volume was determined by transrectal ultrasound. PSAD and fPSA/tPSA were calculated. The diagnostic significance of TuM2-PK, tPSA, fPSA/tPSA and PSAD for PCa in PSA gray area were analyzed using SPSS19.0. Results： Compared with BPH group and elderly prostatitis group,TuM2-PK, fPSA/tPSA and PSAD in PCa group were significantly changed（P〈0.05）; There was no significant difference in t PSA among the three groups. The AUC of these indexes in descending order was TuM2-PK, PSAD, fPSA/tPSA, and tPSA. While the cutoffs of TuM2-PK,tPSA, fPSA/tPSA and PSAD were 24.30 U/mL, 6.60 ng/mL, 0.16 and 0.15 ng/（mL·cm3）, the sensitivity and specificity of diagnosed PCa were 88.9% and 92.1%,72.2% and 44.9%,80.5% and 60.2%,83.3% and 71.8%, respectively. Conclusion： TuM2-PK, fPSA/tPSA and PSAD can increase sensitivity and specificity in the diagnosis of PCa in PSA gray area. And compared with fPSA/tPSA and PSAD, TuM2-PK is more accurate in diagnosing PCa.