河北省直公务员群体前列腺癌筛查意义  

Prostate cancer screening in Hebei provincial civil servants

作　　者：李颖 尚华[4] 赵娜 燕晶晶 王薇 宋彦芳 田苗苗 LI Ying;SHANG Hua;ZHAO Na(Department of Ultrasound,The First Outpatient Department of Hebei Provincial Government,Hebei,Shijiazhuang 050051,China;不详)

机构地区：[1]河北省直属机关第一门诊部超声科,石家庄市050051 [2]河北省直属机关第一门诊部放射科,石家庄市050051 [3]河北省直属机关第一门诊部内科,石家庄市050051 [4]河北医科大学第二医院核医学科 [5]河北医科大学第二医院医学影像科 [6]河北省中医院放射科

出　　处：《河北医药》2023年第9期1414-1417,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20220082)。

摘　　要：目的探讨4982例公务员前列腺癌筛查意义分析。方法调查4982例公务员前列腺癌筛查结果。所有病例根据有无主诉症状分为有症状组(n=1508)和无症状组(n=3474);其中207例受检者接受前列腺穿刺术,取得病理结果。并对筛查出的癌症患者进行年龄、临床分期、病理等级等分析。结果有症状组与无症状组前列腺癌检出率差异无统计学意义(P<0.05)。有症状组比无症状组低分化癌检出率构成比高,差异有统计意义(P<0.05)。无症状组较有症状组分期早。本组DRE的灵敏度及特异度均不高,经直肠超声(TRUS)、前列腺特异性抗原(PSA)的灵敏度与特异度均比DRE明显增高,三者灵敏度由高到低依次为PSA、TRUS、DRE,特异度由高到低依次为TRUS、PSA、DRE,本组DRE+TRUS+PAS灵敏度低(38%),特异度较高(53%)。结论在基层医院、体检中心设置前列腺专项体检套餐,综合应用DRE、TRUS、PSA对>60岁男性不区分有无不适症状进行筛查,以两种或两种以上同时阳性结合患者临床症状和个人意愿来指导患者进行穿刺,对及早发现前列腺癌,改善患者预后有积极作用。Objective To explore the significance of prostate cancer screening among 4,982 civil servants.Methods Prostate cancer screening results were collected from 4,982 civil servants.All cases(n=4,982)were assigned to symptomatic group(n=1,508)and asymptomatic group(n=3,474)based on the presence or absence of chief complaints.Among them,207 cases underwent prostatic puncture surgery,and pathological results were obtained.The age,clinical stage,pathological grade,and other factors of screened cancer patients were analyzed.Results There was no significant difference in the positive rate of prostate cancer between the symptomatic group and the asymptomatic group(P>0.05).The detection rate of poorly differentiated cancer in the symptomatic group was significantly higher than the asymptomatic group(P<0.05).The asymptomatic group had earlier staging than the symptomatic group.Both the sensitivity and specificity of digital rectal examination(DRE)in the symptomatic group were not high.However,the sensitivity and specificity of transrectal ultrasound(TRUS)and prostate specific antigen(PSA)were obviously higher than those of DRE.From high to low,the sensitivity of three indexes were PSA,TRUS and DRE,and the specificity of the three were TRUS,PSA and DRE.The sensitivity and specificity of DRE+TRUS+PAS in the symptomatic group was 38%and 53%,respectively.Conclusion Special prostate physical examination packages are set up in grassroots hospitals and physical examination centers,and DRE,TRUS and PSA are comprehensively applied to screen among men over 60 years old regardless of any uncomfortable symptoms.Patients are guided to undergo puncture with two or more positive symptoms combined with clinical symptoms and personal willingness,which has a positive effect on early detection of prostate cancer and improvement of patient prognosis.

关 键 词：前列腺癌 经直肠超声 前列腺特异性抗原 直肠指检 筛查 

分 类 号：R195[医药卫生—卫生统计学]