前列腺特异性抗原前体及前列腺健康指数相关参数诊断血清总前列腺特异性抗原灰区前列腺癌患者的临床价值  

Clinical value of precursor of prostate-specific antigen and prostate health index related parameters in diagnosing patients with prostate cancer in gay area of serum total prostate-specific antigen

作　　者：朱培江 周密[2] 黄华建 易凌霄 ZHU Peijiang;ZHOU Mi;HUANG Huajian;YI Lingxiao(Department of Uroogy Surgery,Nanxun District Peope′s Hospital,Huzhou 313009,Zhejiang,China;Department of Urology Surgery,Zhejiang People′s Hospital,Hangzhou 310014,Zhejiang,China)

机构地区：[1]湖州市南浔区人民医院泌尿外科,浙江湖州313009 [2]浙江省人民医院泌尿外科,杭州310014

出　　处：《中国性科学》2024年第9期14-18,共5页Chinese Journal of Human Sexuality

基　　金：湖州市公益应用研究项目(2019GYB04)。

摘　　要：目的探讨前列腺特异性抗原前体(p2PSA)及前列腺健康指数(PHI)相关参数诊断血清总前列腺特异性抗原(tPSA)灰区前列腺癌(PCa)患者的临床价值。方法选取2019年1月至2023年1月湖州市南浔区人民医院诊治的286例前列腺病变患者作为研究对象,根据病理学结果将其分组为PCa组(n=78)和良性前列腺病变组(n=208)。所有患者入院后均接受前列腺增强磁共振成像(MRI)检查,并测定血清tPSA、游离前列腺特异性抗原(fPSA)和p2PSA水平,计算%fPSA、%p2PSA和PHI参数,绘制受试者工作特征(ROC)曲线分析MRI第2版前列腺影像报告和数据系统(PI-DADS)评分、血清p2PSA、%p2PSA、PHI单项及联合检测对PCa的诊断价值,分析血清p2PSA、%fPSA、%p2PSA、PHI、MRI PI-DADS评分单项及联合检测评估Gleason评分危险度的价值。结果PCa组MRI PI-DADS评分、血清p2PSA、%p2PSA、PHI水平高于良性前列腺病变组(P<0.05)。MRI PI-DADS评分、血清p2PSA、%p2PSA及PHI联合检测诊断PCa的曲线下面积(AUC)为0.961,灵敏度、特异度分别为83.62%、90.66%,诊断效能高于单项检测(P<0.05)。Gleason评分≥7分、Gleason评分≤6分分别有29例、49例。Gleason评分≥7分组MRI PI-DADS评分、血清p2PSA、%p2PSA和PHI高于Gleason评分≤6分组,%fPSA低于Gleason评分≤6分组(P<0.05)。MRI PI-DADS评分、p2PSA、%fPSA、%p2PSA及PHI联合检测评估Gleason评分危险度的AUC为0.928,灵敏度、特异度分别为89.53%、81.24%,评估效能高于单项检测(P<0.05)。结论p2PSA及PHI相关参数可早期诊断PCa的发生,也能进一步提高对侵袭性PCa的诊断效果。Objective To explore the clinical value of precursor of prostate-specific antigen(p2PSA)and prostate health index(PHI)related parameters in diagnosing patients with prostate cancer(PCa)in gray area of serum total prostate-specific antigen(tPSA).Methods A total of 286 patients with prostate lesions treated in Nanxun District People′s Hospital between January 2019 and January 2023 were enrolled as the research objects.According to pathological results,they were divided into PCa group(n=78)and benign prostatic lesion group(n=208).After admission,all the patients underwent contrast-enhanced magnetic resonance imaging(MRI)examination of prostate.The levels of serum tPSA,free prostate-specific antigen(fPSA)and p2PSA were detected,the parameters of%fPSA,%p2PSA and PHI were calculated.The diagnostic value of score of prostate imaging-reporting and data system version 2(PI-DADS)in MRI,serum p2PSA,%p2PSA,PHI respective and combined detection for PCa were analyzed by receiver operating characteristic(ROC)curves,and the evaluation value of serum p2PSA,%fPSA,%p2PSA,PHI,MRI PI-DADS score respective and combined detection for the risk of Gleason score were analyzed.Results The MRI PI-DADS score,levels of p2PSA,%p2PSA and PHI in PCa group were higher than those in benign prostatic lesion group(P<0.05).The area under curve(AUC),sensitivity and specificity of MRI PI-DADS score combined with serum p2PSA,%p2PSA and PHI in the diagnosis of PCa were 0.961,83.62%and 90.66%respectively,and the diagnostic efficiency of combined detection was greater than that of single index(P<0.05).There were 29 cases with Gleason score≥7 points and 49 cases with Gleason score≤6 points.The MRI PI-DADS score,levels of serum p2PSA,%p2PSA and PHI in the Gleason score≥7 point group were higher than those in the Gleason score≤6 point group,while its%fPSA was lower than that in the Gleason score≤6 point group(P<0.05).The AUC,sensitivity and specificity of MRI PI-DADS score combined with p2PSA,%fPSA,%p2PSA and PHI for evaluating the risk of Gleason

关 键 词：前列腺癌 前列腺健康指数 前列腺特异性抗原前体 GLEASON评分 

分 类 号：R697[医药卫生—泌尿科学]