血清PSA<4.0ng/ml的人群中前列腺癌集团筛查的病理学特征  

The pathological features of prostate cancer screened from the population with serum prostate specific antigen level below 4.0ng/ml

作　　者：陈世范[1] 战伟[1] 李剑[1] 姚敏[1] 杨媚[1] 高洪文[1] 

机构地区：[1]吉林大学第二医院病理科,吉林130041

出　　处：《中国男科学杂志》2008年第11期9-12,共4页Chinese Journal of Andrology

基　　金：吉林省科技发展计划项目(200705200)

摘　　要：目的探讨血清PSA<4.0ng/ml的人群中前列腺癌的病理学特征。方法对长春市15192名男性进行血清前列腺特异性抗原(PSA)检测,其中46名血清PSA<4.0ng/ml伴有直肠指诊检查异常者接受了经直肠超声引导下前列腺6点活检穿刺,并应用组织病理学、免疫组织化学及统计学等方法进行系统的病理学研究和分析。结果(1)血清PSA<4.0ng/ml者有13886名,46人进行了前列腺活检穿刺,活检率为0.33%(46/13886)。(2)46名男性血清PSA值在0.03～3.84ng/ml之间,主要分布在0～1.9ng/ml间,占60.9%。(3)46例前列腺活检病理诊断:良性前列腺增生29例,占63.1%;前列腺癌10例,占21.7%;炎症性病变与肉瘤各3例,分别占6.5%;转移癌1例占2.2%。10例血清PSA<4.0ng/ml的前列腺癌中普通型腺癌5例,以中分化(3/5)、器官内癌(4/5)为主,且血清PSA值较靠近4ng/ml;特殊类型前列腺癌5例,占50%,均为进展期癌,血清PSA值相对较低。结论(1)血清PSA<4.0ng/ml的人群中有前列腺癌存在。(2)血清PSA<4.0ng/ml的人群中前列腺癌以中分化器官内腺癌和特殊类型进展期前列腺癌为主。(3)应用直肠指诊检查(DRE)能检出血清PSA<4.0ng/ml的前列腺癌,且检出率与血清PSA值成正相关,两者联合应用可以提高前列腺癌的检出率。Objectives To investigate the pathological features of prostate cancer screened from the population with serum prostate specific antigen （PSA） level less than 4.0ng/ml. Methods A total of 15192 men in Changchun received detection of serum PSA for prostate cancer screening, and 46 cases with abnormal DRE ana serum PSA below 4.0ng/ml were biopsied for histopathology, immunohistochemistry and statistics analysis. Results （1） Among 13886 men with serum PSA below 4.0ng/ml, only 46 men underwent prostate biopsy, and the biopsy rate was 0.33% （46/ 13886）. （2） The serum PSA level of 46 men ranged from 0.03 to 3.84 ng/ml, and the range of PSA level was mainly in 0-1.9 ng/ml （60.9%）. （3） Of the 46 biopsies cases, 29 cases were benign prostate hyperplasia （BPH） （29146, 63%）, 10 cases were prostate cancer （10146, 21.7%）, 3 cases inflammation （3146, 6.5%）, 3 cases prostatic sarcoma （3/46, 6.5%） and 1 cases metastasis cancer （1/46, 2.2%）. （4） Among 10 prostate cancer cases with serum PSA below 4.0ng/ml, 5 cases were prostatic commom type adenocarcinoma, and 3 cases of them moderately differentiated adenocarcinoma and 4 cases organ confined adenocarcinoma; The other 5 cases were special histological type prostate cancer, and they were all advanced cancer Whose serum PSA level were lower than that of prostatic commom type adenocarcinoma. Conclusion （1） Prostate cancer could be found among the men with serum PSA below 4.0ng/ml. （2） Among prostate cancer men with serum PSA below 4.0ng/ml, most of them were moderately differentiafed and organ confined adenocarcinoma and special histological type advanced prostate cancer. （3） DRE was a important screening method for detection of prostate cancer in population with serum PSA below 4.0ng/ml. The detection rates for prostate cancer using DRE were positively related with PSA value and it can be improved combinihg DRE with serum PSA level.

关 键 词：前列腺特异抗原 前列腺肿瘤/病理学 筛查 

分 类 号：R737.25[医药卫生—肿瘤]