PSA联合前列腺穿刺活检术在泌尿外科门诊前列腺癌机会性筛查中的价值  

The value of prostate specific antigen combined with prostate biopsy in prostate cancer opportunistic screening in urological out-patients

作　　者：何艳 陈晓峰[1,2] 邹义华[1,2] 邓旺龙 He Yan;Chen Xiaofeng;Zou Yihua;Deng Wanglong(Department of Urology,the First People's Hospital of Chenzhou,Chenzhou 423000,China;the First Clinical College of Xiangnan University,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院泌尿外科,郴州423000 [2]湘南学院第一临床学院,郴州423000

出　　处：《国际泌尿系统杂志》2025年第1期57-61,共5页International Journal of Urology and Nephrology

基　　金：2020年湘南学院医院联合项目(2020XJ143)。

摘　　要：目的探讨对泌尿外科门诊就诊的前列腺癌高危人群行前列腺特异抗原(PSA)和前列腺穿刺活检的价值,明确PSA检测在诊断前列腺癌中的作用。方法回顾性分析2020年9月至2022年12月在郴州市第一人民医院泌尿外科门诊接受PSA检测的924例前列腺癌高危人群的临床资料,对于PSA检测结果≥4 ng/mL的患者,建议1个月后进行PSA复查;复查时PSA≥4 ng/mL的患者进行前列腺穿刺活检,对于超过1个月未就诊的PSA≥4 ng/mL患者,通过电话提醒其进行PSA复查并登记是否复查。分析比较前列腺癌高危人群的肿瘤发生的风险因素。结果PSA值异常者252例,PSA复查68例,复查率为26.98%;通过前列腺穿刺活检确诊前列腺癌24例,占检测总人数的2.60%。前列腺癌高危人群的年龄为45~92岁,中位年龄63岁。年龄越大,PSA值越高,二者呈正相关(r=0.40,P<0.001)。随着年龄增加,PSA复查率和肿瘤发生率均升高(均P<0.01)。随着PSA值增加,PSA复查率和肿瘤发生率均升高(均P<0.01)。结论泌尿外科门诊患者行PSA联合前列腺穿刺活检术的前列腺癌机会性筛查,年龄越大,而PSA越高,PSA复查率均随年龄和PSA增加而升高,但整体PSA的复查率仍较低,前列腺癌检出率较高,前列腺癌发生率随年龄和PSA增加而升高,>80岁患者的前列腺癌发病率最高。Objective The objective of this study is to assess the diagnostic value of prostate specific antigen(PSA)and prostate biopsy in high-risk patients with prostate cancer attending the urology outpatient department,while elucidating the role of PSA detection in the diagnosis of prostate cancer.Methods The clinical data of 924 patients at high risk of prostate cancer who received PSA test in the Urology Department of Chenzhou First People's Hospital from September 2020 to December 2022 were retrospectively analyzed.For patients with PSA test results≥4 ng/mL,PSA reexamination is recommended one month later.Patients with PSA≥4 ng/mL should undergo prostate puncture biopsy.Patients with PSA≥4 ng/mL who have not seen a doctor for more than one month should be reminded to undergo PSA reexamination by telephone and register whether to do so,so as to analyze and compare the risk factors of tumor occurrence in high-risk groups of prostate cancer.Results There were 252 cases of abnormal PSA value,68 cases of PSA reexamination,the reexamination rate of 26.98%.Twenty-four patients were diagnosed with prostate cancer through prostate biopsy,accounting for 2.60%of the total number tested.The men at high risk of prostate cancer ranged in age from 45 to 92 years,with a median age of 63 years.The older the age,the higher the PSA value,and the two were positively correlated(r=0.40,P<0.001).The rate of PSA reexamination and the incidence of tumor increased with the increase of age(all P<0.01).With the increase of PSA value,the reexamination rate of PSA and the incidence of tumor were increased(all P<0.01).Conclusions PSA combined with prostate biopsy in urological outpatients for opportunistic screening of prostate cancer,the older the age,the higher the PSA,the PSA reexamination rate increased with the increase of age and PSA,but the overall PSA reexamination rate was still low,the detection rate of prostate cancer was high,and the incidence of prostate cancer increased with the increase of age and PSA.The incidence of prostate

关 键 词：前列腺肿瘤 前列腺穿刺活检 前列腺特异抗原 

分 类 号：R737.25[医药卫生—肿瘤]