- 期刊
The Performance of PSA-RIACT in Different Agitation Rate
震盪速率對血清攝護腺特異抗原放射免疫分析檢驗結果之影響
摘要
背景：血清攝護腺特異抗原(Prostate specific antigen, PSA)是由攝護腺表皮細胞分泌的一種單股醣蛋白，主要功用爲幫助精液的液化作用。PSA是目前攝護腺癌最有價值的腫瘤標誌，不僅可用於攝護腺癌的篩檢及診斷，在腫瘤分期和治療效果的追蹤也佔有重要角色。在以PSA-RIACT試劑檢測PSA的標準流程中，須要以400rpm震盪處理兩小時，但是因爲在本實驗室中，能達到400rpm的震盪儀數量有限，因此在檢驗排程上，會用到此儀器的檢驗必須錯開其操作時間。因須考慮各檢驗項目所需時間、檢測頻率、每日檢體數量、檢驗人力及其他所需儀器之使用等因素，再加上須配合臨床醫師門診時問需求。爲減少排程上的困擾，並確保檢驗結果不受影響，本研究評估使用較低的震盪速率來替代對檢驗結果產生的影響性。 方法，本研究採集了63位因臨床需要而接受PSA檢測的住院息者，向本實驗室資深放射師分別依標凖作業流程(400rpm)及實驗流程（200rpm，其他步驟均相同）進行操作，以成對student t統計法比較兩種方式所得之數據差異。 結果：在63位受檢者中，以標準操作所得之PSA檢測結果：有38位(60%)小於4ng/ml，17位(27%)介於4-10ng/ml，6位(9.5%)介於10-50ng/ml，2位(3%)大於50ng/ml。以標準及實驗流程所得的結果有很好的相關性(r=0.99)，且兩者並無統計上的差異(P=0.27)。所有受檢者之後續臨床處置均未因此而改變。 結論，由於此兩種檢測方式所得到的檢驗結果不但相關性佳，統計上無差異，且不影響患者復續之處置。當需要時，以200rpm的轉速替代，可爲另一個選擇。
並列摘要
Background: PSA (prostate specific antigen) is a serine protease of the kallikrein group, found almost exclusively in the prostate. It is a glycoprotein with a molecular weight of 34,000D, which plays a major role in the liquefaction of seminal fluid. According to the standard operative procedure of the PSA-RIACT, agitation with 400 rpm for 2 h is required. However, the number of the shakers that can reach 400 rpm is limited in number in our laboratory. The examination items that require the same instrument should not be operated in the same day. Arranging the examination schedule is not easy in a laboratory since all the following factors should be considered as well: the schedule of the physicians' out patient clinic, the duration of the examination, the frequency of the examination, the number of the samples per day, the capacity of the radiologist/technician to handle the examination and the instruments' capacity. If the different agitation rate plays no role in the results of the radioimmunoassay, it would be much easier to set the schedule of the daily works. Methods: We collected 63 blood samples from male patients arranged to check the PSA level under the physician's prescription during hospitalization. Informed consents were collected. All the samples were analyzed by an experienced technician in the radioimmunoassay laboratory at Taichung Veterans General Hospital (VGHTC) according to the standard operation procedure of prostate specific antigen (with the agitation rate of 400 rpm) as the controlled group. The examined group was handled according to the standard operation procedure of prostate specific antigen, but with different agitation rate (200 rpm). Pairs of sample were handled by the same technician with the same culture time. The sampling was finished by an automatic pipetting station. The results of the two groups were evaluated by paired student t test and the Pearson's correlation coefficient. Results: For the 63 included cases, the PSA levels were lower than 4 ng/ml in 38 cases (60%), between 4 ng/ml to 10 ng/ml in 17 cases (27%), between 10 ng/ml to 50 ng/ml in 6 cases (9.5%), and higher than 50 ng/ml in 2 cases (3%). There was good correlation of the paired results in 400 rpm and 200 rpm with the Pearson's correlation coefficient of 0.99. The results between 400 rpm and 200 rpm were no statistical difference (P=0.27). Conclusion: Since the results of PSA analysis shows no statistical significance in 400 rpm and 200 rpm, it would be an alternative to incubate the samples in 200 rpm when the 400 rpm-shakers are not available.