兰州地区目标人群前列腺癌筛查及异常PSA值影响因素分析  

Screening of prostate cancer and analysis of influencing factors of the abnormal values of PSA among the target population in Lanzhou area

作　　者：李绪 李荣欣 关心 蒲九州 刘帅 王亚楠[1] 董治龙[1] Li Xu;Li Rongxin;Guan Xin;Pu Jiuzhou;Liu Shuai;Wang Yanan;Dong Zhilong(Department of Urology,Lanzhou University Second Hospital,Lanzhou 730000,Gansu Province,China)

机构地区：[1]兰州大学第二医院泌尿外科,甘肃兰州730000

出　　处：《中国男科学杂志》2022年第3期3-13,共11页Chinese Journal of Andrology

基　　金：科技部国家重点研发计划(2017YFC0908001)。

摘　　要：目的了解兰州地区目标人群前列腺癌(prostate cancer,PCa)的发病率,分析除前列腺癌、前列腺炎等因素外,其他可能对总前列腺特异性抗原(total prostate specific antigen,TPSA)检测值造成影响的因素。方法于2020年12月10日至2021年5月29日期间,在甘肃省兰州市城关区14个社区卫生服务中心和6家医院(以下简称“社区”)招募40岁以上无癌症及其他重大疾病病史的男性,进行基于血清TPSA值的前列腺癌筛查及问卷调查。结果1461人完成TPSA检测,其中1295人问卷信息完整,6人确诊为前列腺癌。年龄<55周岁的对象TPSA异常的检出率仅为0.7%(异常:正常=1∶138),当年龄≥75周岁时,TPSA异常的检出率可达22.2%(异常:正常=30∶105)(P=0.000)。城关主城区和兰州周边地区较城关非主城区具有更高的TPSA异常值检出率。喝青茶或白茶对象TPSA异常检出率为2.4%(异常:正常=3∶122)明显低于不喝青茶或白茶对象TPSA异常的检出率9.6%(异常:正常=112∶1058)(P=0.007)。吸烟对象相较于不吸烟对象其TPSA异常值检出率增加5.091倍,且每天多吸一支烟,TPSA异常值检出的概率增加2.8%。TPSA异常组对象每日吸烟量高于正常组(21.17±14.78支VS 16.57±10.80支,P=0.002),累计吸烟量亦更高(822.47±489.99年支VS 648.22±495.46年支,P=0.010)。二元logistic回归分析显示,对象来自不同类型的社区、家庭烹饪时添加味精的频率、家庭以外就餐的频率、是否食用水果、是否吸烟、吸烟者每日吸烟量、是否喝青茶或白茶以及采集时对象的年龄都会对TPSA异常的检出率产生影响。结论目标人群PCa检出率较高,约为0.41%(410.68/10万),广大医务工作者及中老年男性需要足够重视。研究对象年龄、地区及吸烟、饮青茶或白茶、摄入味精等生活习惯对TPSA异常值的检出率具有影响。研究对象文化程度、职业、BMI分层等可能对TPSA值异常的检出率没有影响。Objective To understand the incidence of prostate cancer(PCa)in the target population in Lanzhou area,and analyze the other related factors affecting the detection values of total prostate specific antigen(TPSA)in addition to the factors of prostate cancer and prostatitis.Methods Males over 40 years old who did not suffer from cancer or other serious diseases were recruited for serum TPSA-based prostate cancer screening and questionnaire survey from 14 community health service centers and 6 hospitals in the communities of Chengguan District,Lanzhou City,Gansu Province from December 10,2020 to May 29,2021.Results Total of 1461 males received serum TPSA test,and 1295 of them completed questionnaire information,and 6 were diagnosed as prostate cancer.The positive rate of serum TPSA was only 0.7%(abnormal:normal=1∶138)in the males under 55 years old,and 22.2%(abnormal:normal=30∶105)in the males over 75 years old(P=0.000).Compared with the non-main urban area of Chengguan,the main urban area of Chengguan and the surrounding area of Lanzhou have a higher positive rate of serum TPSA.The positive rate of serum TPSA in the males who drank Oolong tea or white tea(2.4%,abnormal:normal=3∶122)was obviously lower than that in the males who did not(9.6%,abnormal:normal=112∶1058)(p=0.007).The positive rate of serum TPSA in smokers increased by 5.091 times compared with non-smokers,and the probability of positive TPSA increased by 2.8%with one more cigarette per day.The amount of smoking per day in the positive TPSA group was higher than that in the negative group(21.17±14.78 cigarettes VS 16.57±10.80 cigarettes,p=0.002),and the cumulative smoking volume was also higher(822.47±489.99 VS 648.22±495.46,p=0.010).Binary logistic regression analysis showed that patients from different types of communities,the frequency of adding monosodium glutamate during family cooking,the frequency of eating outside the family,whether to eat fruit,whether to smoke,the daily smoking amount of smoking patients,whether to drink Oolong tea

关 键 词：前列腺肿瘤 筛查 前列腺特异性抗原 影响因素分析 

分 类 号：R737.25[医药卫生—肿瘤]