血清PSA水平在前列腺穿刺患者中的临床意义  

The clinical significance of serum PSA level in patients with prostate biopsy

作　　者：熊飞龙[1] 何卫阳[1] 李信[1] 王明[1] 

机构地区：[1]重庆医科大学附属第一医院泌尿外科,400016

出　　处：《重庆医学》2016年第35期4974-4976,共3页Chongqing medicine

摘　　要：目的探讨血清前列腺特异性抗原(PSA)在前列腺穿刺患者中的临床价值。方法收集该院2013年1月至2014年12月361例行前列腺穿刺患者的血清PSA检测、穿刺病理检查及全身骨显像等资料,依据不同血清PSA水平将其分为A组(PSA≤4.0ng/mL)、B组(4.0ng/mL<PSA≤10.0ng/mL)、C组(10ng/mL<PSA≤20ng/mL)、D组(PSA>20.0ng/mL),比较各组前列腺穿刺阳性率,以及不同PSA水平前列腺穿刺阳性患者的骨转移发生率。结果 A、B、C、D 4组患者前列腺穿刺阳性率分别为9.09%、9.84%、26.21%、74.73%,其中A、B组前列腺穿刺阳性率与D组比较,B组与C组比较,差异均有统计学意义(P<0.05)。在B组中,游离态PSA/总PSA比值(F/T)≤0.16与F/T>0.16的患者穿刺阳性率比较,差异无统计学意义(P>0.05)。前列腺穿刺阳性患者中,PSA>20ng/mL者骨转移发生率高于PSA≤20ng/mL者,差异有统计学意义(P<0.05)。结论血清PSA水平越高,前列腺穿刺阳性率越高;初诊前列腺癌患者血清PSA>20ng/mL建议行全身骨显像检查。Objective To explore the clinical significance of serum prostate specific antigen（PSA） level in patients undergoing prostate biopsy. Methods Detection results of serum PSA levels and prostate biopsy,and whole-body bone scintigraphies of 361 cases of patients undergoing prostate biopsy from January 2013 to December 2014 in our hospital were collected. These patients were divided into 4 groups according to serum levels of PSA, namely group A（PSA≤4.0 ng/mL）, group B（4.0 ng/mL〈PSA≤ 10. 0 ng/mL） ,group C（10 ng/mL〈PSA≤20 ng/mL） and group D（PSA〉20.0 ng/mL）. The positive rate of prostate biopsy was compared among the 4 groups, the incidence of bone metastases was compared among patients who were with positive prostate biopsies in different serum levels of PSA, as welt. Results The positive rate of prostate biopsy in group A,B,C and D was 9.09 %, 9.84 %, 26.21 % and 74.73 %, respectively. The positive rate of prostate biopsy in group A and B compared with group D, and that between group B and group C were statistically significant different（P〈0.05）. In group B, no statistically significant difference was found in the positive rate of prostate biopsy between patients whose free PSA/total PSA（F/T） ratio was equal or less than 0.16 and patients whose F/T ratio was more than 0.16 （P〉0. 05）. In patients with positive rate of prostate biopsy, the incidence of bone metastases in those PSA〉20 ng/mL was higher than that in those PSA≤20 ng/mL, there was statistically significant difference （P〈0.05）. Conclusion The serum PSA level is higher,the positive rate of prostate biopsy is higher. When the serum level of PSA was higher than 20.0 ng/mL in newly diagnosed patients with prostate cancer,the radionuclide bone scans should be suggested.

关 键 词：前列腺特异性抗原 前列腺癌 前列腺穿刺 骨转移 

分 类 号：R737.25[医药卫生—肿瘤]