PSA、PSAD、f/tPSA对前列腺癌的诊断及穿刺后Gleason评分的预测  

PSA,PSAD,f / t PSA for Diagnosis of Prostate Cancer and Prediction of Post Needle Biopsy Gleason Score

作　　者：刘洋[1] 王涌泉[1] 

机构地区：[1]哈尔滨医科大学附属第一医院泌尿外科,150001

出　　处：《医学研究杂志》2016年第2期116-120,共5页Journal of Medical Research

摘　　要：目的 对比PSA、前列腺特异性抗原密度（PSAD）、f／tPSA对前列腺癌（prostatecancer，PCa）的诊断及穿刺后Glea—son评分（Gleasonscore，GS）的预测作用。方法收集2011年1月～2015年1月间笔者医院泌尿外科以前列腺增生住院患者，根据血清PSA值可疑前列腺癌，而后行前列腺穿刺活检。穿刺病理结果总体人群分为前列腺癌（PCa）组和前列腺增生（BPH）组。患者Gs根据临床生物化学和病理学实验室得出。采用受试者工作特征曲线（ROC）对PSA、PSAD、f／tPSA分析比较；采用线性回归分析确定其和术后Gs之间的关系。结果PCa组患者的PSA、PSAD明显高于BPH组（P=0．000），f／tPSA明显低于BPH组（P〈0．001）。对PSA不同的区段进行ROC曲线分析，得出诊断灰区（PSA4～10ng／ml，56例）PSAD差异有统计学意义[P=0．000，曲线下面积（AUC）=0．976]，f／tPSA及PSA差异无统计学意义（P〉0．05）；PSA4～20ng／ml时（151例）PSAD及f／tPSA差异有统计学意义（AUC分别为0．829、0．673，P=0．000），PSA差异无统计学意义（P〉0．05）；大于20ng／ml时（96例）PSAD及PSA差异有统计学意义（AUC分别为0．785、0．750，P=0．000），f／tPSA差异无统计学意义（P〉0．05）；纳入全部样本（253例）后则全部差异有统计学意义（AUC分别为0．795、0．868、0．611，P=0．000）。GS4—10分，平均7．19±1．06分，线性回归结果提示PSA和PSAD与术后Gs均呈正相关（分别是p=0．01，P〈0．05；B=0．274，P〈0．05），而f／tPSA与Gs则无相关性。结论PSA、PSAD、f／tPSA对前列腺癌具有诊断作用且PSAD〉PSA〉f／tPSA，PSA及PSAD与穿刺后GS呈正相关。Objective To compare PSA, prostate specific antigen density （PSAD） , f / tPSA for diagnosis of prostate cancer and prediction of post Needle biopsy Gleason score （Gleason score, GS）. Methods Patients who were hospitalized because of prostatic hyperplasia from January 2011 to January 2015 were collected in Department of Urology. The subjects were conducted prostate biopsy after serum PSA measurement because of suspected prostate cancer. The patients were grouped into prostate cancer （PCa） group and benign prostatic hyperplasia （BPH） group according to the results of prostate biopsy. Gleason scores of patients were determined by examining the records of clinical biochemistry and pathology laboratory. Receiver operating characteristic curve （ROC） was used to compare the value of PSA, PSAD and f/tPSA. Linear regression analyses were performed to assess relationships between PSA, PSAD or f/tPSA and GS. Resuits The PSA and PSAD of the patients in the PCa group were significantly higher than those in BPH group （P = 0. 000）, but f/tPSA was significantly lower in BPH group （P = O. 000）. ROC curve analyses were performed in different groups of PSA. The results showed that there were significant differences between BPH and PCa patients in PSAD [ area under the curve（AUC） = 0. 976, P = 0. 000 ] in the diagnostic gray zone with PSA 4 - 10ng/ml（56 patients） , in PSAD and f/tPSA （ AUC were 0. 829 and 0. 673, P = 0. 000, respectively） in group with PSA 4 - 20ng/ml （ 151 patients） ; in PSAD and PSA （ AUC were 0. 785 and 0. 750, P = 0. 000, respectively） in group with PSA 〉 20ng/ml （ 96 patients） ; in PSA, PSAD and f/tPSA （ AUC were 0. 795,0. 868 and 0.611, P = 0. 000, respectively） in whole group （253 cases）. GS were 4 - 10, average 7.19 ± 1.06. PSA and PSAD were positively correlated to postoperative GS by linear regression analyses （13=0.01, P〈0.05;13=0.274, P〈0.05, respectively）, but not f/tPSA. Conclusion PSA, PSAD, f/tPSA were diagnostic tools for prostat

关 键 词：PSA PSAD f/tPSA诊断Gleason评分预测 

分 类 号：R73[医药卫生—肿瘤]