50岁以下PSA升高患者临床特点分析  

Clinical Characteristics of men with serum PSA>4.0ng/ml before 50 years: a single center based study

作　　者：余忠伟[1] 孙福康[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《中国男科学杂志》2017年第3期10-13,共4页Chinese Journal of Andrology

摘　　要：目的分析≤50岁患者PSA升高原因及PSA水平变化趋势。方法回顾性分析2012年至2015年于我中心体检发现血清总PSA>4.0ng/m L的321例患者临床资料,比较≤50岁患者与>50岁患者血清PSA水平、f PSA/t PSA、前列腺穿刺结果的差异。结果≤50岁患者共53例,平均年龄40(21~50)岁,血清PSA为(7.645±2.734)ng/m L。PSA介于4~10ng/m L的≤50岁患者f PSA/t PSA为0.090±0.048。≤50岁患者PSA和f PSA/t PSA明显低于>50岁患者。环丙沙星联合坦索洛新未能明显降低PSA水平。19例≤50岁患者接受超声引导下经直肠前列腺穿刺,结果均为阴性。结论 50岁以下患者PSA升高的主要原因是慢性前列腺炎和(或)前列腺增生,其PSA水平多介于4~10ng/m L灰色区间,应以主动监测为主。Objective To figure out the reason why serum prostate-specific antigen （PSA） is elevated in men before 50 years and how to manage it. Methods We retrospectively reviewed clinical data of 321 patients with a PSA serum concentration of more than 4ng/ml from 2012 to 2015 in our center. The level of PSA, fPSA/tPSA and prostate biopsy outcome were comparatively analyzed between patients before and after 50 years old. Results Of 321 patients, 53 patients are no elder than 50 years old, with mean age 40 years （21-50 years）. The level of serum PSA and fPSA/tPSA value in patients ±〈50 years at diagnosis are （7.645±2.734）ng/mL and （0.090±0.048） respectively, serum PSA level and fPSA/ tPSA value in patients≤50 years old are significantly lower than in patient 〉50 years old. Combination of tamsulosin and ciprofloxacin therapy failed to decrease serum PSA in patients younger than 50 years old. 19 patients were applied to transreetal ultrasound guided prostate biopsy and turned out to be with negative outcome. Conclusion Our study suggest that elevated serum PSA level in patients ≤50 years was mainly caused by chronic prostatitis and benign prostate hyperplasia. PSA are mainly moderately elevated and mostly range from 4.0-10ng/mL in men younger than 50 years. Active surveillance is a proper choice for these patients.

关 键 词：前列腺肿瘤 前列腺特异抗原 筛查 

分 类 号：R737.25[医药卫生—肿瘤]