前列腺健康指数在不同tPSA区间段诊断前列腺癌的临床价值研究  

Clinical value of prostate health index in the diagnosis of prostate cancer in different tPSA intervals

作　　者：周金才 居峰 倪颖 王岗 ZHOU Jincai;JU Feng;NI Ying;WANG Gang(Department of Urology,Northern Jiangsu People's Hospital Jianhu Branch,Jianhu 224700,China)

机构地区：[1]苏北人民医院建湖分院泌尿外科,江苏建湖224700

出　　处：《现代医学》2023年第7期918-922,共5页Modern Medical Journal

基　　金：2020年盐城市医学科技发展计划项目(YK2020102)。

摘　　要：目的:分析前列腺健康指数(PHi)在不同总前列腺特异抗原(tPSA)区间段诊断前列腺癌的临床价值。方法:选定本院2019年1月至2022年1月住院治疗且tPSA>4 ng·ml^(-1)的110例前列腺癌患者作为观察组,以及同期tPSA>4 ng·ml^(-1)的110例前列腺增生(BPH)患者作为参照组,均进行前列腺特异性抗原同源异构体2(p2PSA)、游离前列腺特异性抗原(fPSA)、tPSA检测,计算PHi值,比较不同tPSA区间和Gleason分组中p2PSA、fPSA、tPSA、PHi,并评价p2PSA、fPSA、tPSA、PHi对前列腺癌的诊断效能。结果:观察组p2PSA、tPSA、fPSA、PHi均高于参照组(P<0.05)。Gleason评分≥7分组p2PSA、tPSA、PHi高于Gleason≤6分组(P<0.05)。在tPSA灰区(4 ng·ml^(-1)<tPSA≤10 ng·ml^(-1))中,观察组的PHi显著高于参照组(P<0.05),而在其他分区中差异不显著。同时在此区间中,PHi的ROC曲线下面积(AUC)、特异度、灵敏度、阳性预测值、阴性预测值均高于p2PSA和fPSA(P<0.05)。结论:PHi在4 ng·ml^(-1)<tPSA≤10 ng·ml^(-1)区间的前列腺癌中具有较高的诊断效能,临床可作为tPSA灰区中诊断前列腺癌的重要指标。Objective:To analyze the clinical value of prostate health index(PHi)in the diagnosis of prostate cancer at different intervals of total prostate specific antigen(tPSA).Methods:110 patients with prostate cancer(tPSA>4 ng·ml^(-1))hospitalized in our center from January 2019 to January 2022 were included as the observation group,and 110 patients with benign prostatic hyperplasia(tPSA>4 ng·ml^(-1))in the same period were included as the reference group.p2PSA,fPSA and tPSA were detected,and the PHi values were calculated based on them.p2PSA,fPSA,tPSA and PHi in different tPSA intervals and Gleason groups were compared to evaluate their diagnostic efficiency.Results:p2PSA,tPSA,fPSA and PHi in the observation group were all higher than those in the reference group(P<0.05).p2PSA,tPSA and PHi in Gleason score≥7 group were all higher than those in≤6 group(P<0.05).In the tPSA gray zone(4 ng·ml^(-1)<tPSA≤10 ng·ml^(-1)),the PHi of the observation group was significantly higher than that of the reference group(P<0.05),but there was no significant difference in other tPSA intervals.At the same time,Area Under Curve(AUC)of receiver operating characteristic curve,specificity,sensitivity,positive predictive value and negative predictive value of PHi were higher than those of p2PSA and fPSA in this interval(4 ng·ml^(-1)<tPSA≤10 ng·ml^(-1),P<0.05).Conclusion:PHi has high diagnostic efficiency in prostate cancer in the range of 4 ng·ml^(-1)<tPSA≤10 ng·ml^(-1) and can be used as an important index to diagnose prostate cancer in the gray zone of tPSA.

关 键 词：前列腺健康指数 前列腺癌 总前列腺特异抗原 诊断效能 

分 类 号：R446.11[医药卫生—诊断学] R737.25[医药卫生—临床医学]