血清攝護腺特異抗原(PSA)是關於攝護腺應用最重要的腫瘤標記，但尿液中的PSA則很少被注意到。本研究在探討單次中段尿液，24小時尿液及血清PSA值的相關性。本研究共有98個病患，包括20個攝護腺癌(CaP)和78個良性攝護腺增生(BPH)病患(皆有病理證實)，前34例只測定早上第一次中段尿液，傍晚單次中段尿液及血清PSA值，其PSA值分別為336±223,443±208及11.7±4.4ng/ml。另64例則測定24小時尿液及血清PSA值，其BPH及CaP患者的血清PSA值分別為9.9±1.6及25.7±8.2ng/ml，24小時尿液PSA值分別為120±20及72±31ng/ml，24小時尿液PSA總豆則分別為243±38及125±46μg/24h。以上兩組，其血清和尿液PSA值相關性皆差。另外本研究亦發現：不管是BPH或CaP患者，其尿液PSA值多少高於血清，但由於尿液PSA值(不管是單性中段或24小時連液)變化很大，所以尿液PSA仍無法取代血清PSA的臨床應用。

This study is conducted to clarify the correlation between serum and urinary prostate-specific antigen (PSA) and to find the difference in urinary PSA between patients with prostate cancer (CaP) and those with benign prostatic hyperplasia (BPH). PSA levels of 20 patients with prostatic cancer and 78 patients with BPH were determined using the ELSA-PSA2 kit. For the first 14 patients, the PSA of serum and first-voided urine in the morning were detected. For the following 20 patients, serum PSA, as well as morning and evening midstreamurinary PSA were examined. Serum PSA and 24-h urinary PSA were measured for the remaining 64 patients. PSA levels of spot midstream urine specimens were highly variable between morning and evening urine, but they were usually higher than and poorly correlated with those of serum. PSA levels of morning first-voided, evening urine, and serum were 336±233,443±208, and 11.7±4.4ng/ml, respectively. For the remaining 64 patients, serum PSA levels of BPH and CaP patients were 9.9±1.6and 25.7±8.2ng/ml, respectively;while, their 24-h urinary PSA amounts were 243±38 and 125±46 ug, respectively (p=0.059). The correlation between serum PSA and 24-h urinary PSA amounts was poor as well. For either spot or 24-h urine, urinary PSA is highly variable and is usually higher than serum PSA. However, 24-h urine specimens can precisely determine the level of PSA secretion of the lower urinary tract. The 24-h urinary PSA amounts of BPH patients were higher than those of CaP patients, but the overlapping area between these 2 groups was very large. Therefore it is not suitable to use urinary PSA as a substitute for serum PSA for clinical application in prostatic diseases. (J Rrol R.O.C., 9:132-137,1998)