基于社区联动模式下PSA初筛的上海市松江乡镇地区老年男性前列腺癌筛查结果分析与筛查模式探索  

Analysis of prostate cancer screening results and exploration of screening model for elderly males in Songjiang Rural Areas of Shanghai City based on PSA preliminary screening under the community linkage mode

作　　者：方道成 吴凌枫[2] 陈立新[1] 唐春华[1] 王勇[1] 李慧[1] 王辉[1] 张奎[1] 孙双权[1] 高强[1] 董明渊 王朝 杨谊[1] 杨志伟 柳静 杜文娣 施贞兵 毕淑梅 温晖 Fang Daocheng;Wu Lingfeng;Chen Lixin;Tang Chunhua;Wang Yong;Li Hui;Wang Hui;Zhang Kui;Sun Shuangquan;Gao Qiang;Dong Mingyuan;Wang Chao;Yang Yi;Yang Zhiwei;Liu Jing;Du Wendi;Shi Zhenbing;Bi Shumei;Wen Hui(Department of Urology,Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai Regional Medical Center,Shanghai 201600,China;Surgical Teaching and Research Section,Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China;Yexie Town Community Health Service Center of Songjiang District,Shanghai 201600,China;Xinbang Town Community Health Service Center of Songjiang District,Shanghai 201600,China;Nursing Department,Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,National Nursing Science Education base,Shanghai 201600,China)

机构地区：[1]上海交通大学医学院附属松江医院泌尿外科,上海市区域性医疗中心,上海201600 [2]上海交通大学医学院附属松江医院外科教研室,上海201600 [3]上海市松江区叶榭镇社区卫生服务中心,上海201600 [4]上海市松江区新浜镇社区卫生服务中心,上海201600 [5]上海交通大学医学院附属松江医院护理部,全国护理科普教育基地,上海201600

出　　处：《中华预防医学杂志》2025年第2期230-234,共5页Chinese Journal of Preventive Medicine

基　　金：上海市松江区重点学科建设项目(24SJYXZDA03);上海市松江区科普项目(2023SJKPZ011)。

摘　　要：本研究旨在通过实施基于社区联动模式下的前列腺特异性抗原(PSA)初步筛查,分析上海市松江乡镇地区老年男性前列腺癌(PCa)的筛查结果和流行病学特征,并探索一种有效的筛查模式。采用回顾性观察性研究方法,收集2022年6月至2024年6月期间,在上海交通大学医学院附属松江医院联合上海松江地区多家社区卫生服务中心,通过义诊及年度体检接受PSA筛查的居民数据,对tPSA>10 ng/ml和4 ng/ml≤tPSA≤10 ng/ml且f/tPSA比值异常者建议行前列腺穿刺活检。并对筛查出的PCa患者进行临床特点的分析。通过电话回访、家庭医生家访等模式结合加强宣教。结果显示,共有17 198名居民接受了筛查,其中4 ng/ml≤tPSA≤10 ng/ml者共2 234名(12.99%),tPSA>10 ng/ml者257名(1.49%)。最终417名居民进行了前列腺穿刺活检,其中171名居民穿刺结果提示为PCa,穿刺阳性率为41.00%,PCa检出率为0.99%,PCa患者的病理分型以腺癌为主(168例,98.24%)。在146例接受诊治的PCa患者中,风险分组以中、高危患者为主(124例,84.93%)。并且随着筛查模式的优化,后期门诊就诊人数比例较前明显上涨。综上,基于社区联动的PSA初筛模式在上海市松江乡镇地区老年男性PCa筛查中显示出较高的有效性,流行病学结果显示该地区PCa患者主要以中、高危风险群体为主,提示应加强早期筛查与健康教育。This study aims to analyze the screening results and epidemiological characteristics of prostate cancer(PCa)among elderly males in the rural areas of Songjiang,Shanghai City,through the implementation of a preliminary prostate-specific antigen(PSA)screening based on a community-linkage model,and to explore an effective screening approach.A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine,in collaboration with multiple community health service centers in Songjiang District,Shanghai City,between June 2022 and June 2024,through free clinics and annual health examinations.Prostate biopsy was recommended for individuals with total PSA(tPSA)levels>10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA(f/tPSA)ratios.Clinical characteristics of detected PCa patients were analyzed.Follow-up was conducted through phone calls and home visits by family doctors,coupled with enhanced health education.The results indicated that a total of 17198 residents participated in the screening,among which 2234(12.99%)had tPSA levels between 4 ng/ml and 10 ng/ml,and 257(1.49%)had tPSA levels>10 ng/ml.Ultimately,417 residents underwent prostate biopsy,with 171 being diagnosed with PCa,yielding a positive biopsy rate of 41.00%and a PCa detection rate of 0.99%.The predominant pathological subtype among PCa patients was adenocarcinoma(168 cases,98.24%).Of the 146 PCa patients who received treatment,the majority were classified as intermediate or high-risk(124 cases,84.93%).Furthermore,with the optimization of the screening model,there was a significant increase in the proportion of subsequent outpatient visits.In conclusion,the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang,Shanghai City.Epidemiological findings revealed that PCa patients in this region are primarily com

关 键 词：前列腺特异性抗原 前列腺癌 流行病学 筛查 

分 类 号：R737.25[医药卫生—肿瘤]