中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2012年
4期
272-277
,共6页
高建国%田斌群%王行环%胡小屏%秦战停%卢猛
高建國%田斌群%王行環%鬍小屏%秦戰停%盧猛
고건국%전빈군%왕행배%호소병%진전정%로맹
前列腺上皮内瘤%前列腺增生%前列腺癌%回顾性研究
前列腺上皮內瘤%前列腺增生%前列腺癌%迴顧性研究
전렬선상피내류%전렬선증생%전렬선암%회고성연구
Prostatic intraepithelial neoplasia%Benign prostatic hyperplasia%Prostate cancer%Retrospective study
目的 探讨血清总PSA(t-PSA)、血清游离PSA与总PSA比值(f/t)、前列腺体积(PV)及PSA密度(PSAD)与前列腺上皮内瘤(prostatic intraepithelial neoplasia,PIN)的相关性及临床意义.方法 收集我院2004年1月至2009年12月PIN患者165例,其中低级别PIN( low grade prostatic intraepithelial neoplasia,LGPIN)31例,高级别PIN(high grade prostatic intraepithelial neoplasia,HGPIN)134例；以病理确诊的BPH患者252例和前列腺癌(prostate cancer,PCa)患者49例为对照组.BPH、LGPIN、HGPIN、PCa组年龄分别为(70.13±0.43)、(70.97±1.28)、(70.74±0.64)、(70.37±1.40)岁,IPSS分别为20.20±0.88、14.71±3.42、20.19±1.24、19.27±2.73,PV分别为(58.07±3.58)、(56.01±7.52)、(60.74±4.81)、(47.56±6.54)ml.分析比较4组间PSA、f/t、PSAD等的相关性和差异. 结果 4组年龄、IPSS和PV比较差异均无统计学意义(P＞0.05).BPH、LGPIN、HGPIN、PCa组PSA值分别为(5.65±0.38)、(5.86 ±0.81)、(8,91±0.71)、(13.80±1.83) μg/L,f/t平均值分别为0.26 ±0.01、0.24±0.02、0.22±0.01、0.17±0.01；PSAD值分别为(0.11±0.01)、(0.10±0.02)、(0.19±0.03)、(0.48 ±0.12)μg/(L·cm3).PSA、f/t和PSAD在LGPIN和HGPIN组间差异无统计学意义(P＞0.05),在LGPlN和BPH组间差异无统计学意义(P＞0.05),在LGPIN和PCa组间差异有统计学意义(P＜0.05),在HGPIN和BPH组间差异有统计学意义(P ＜0.05)；PSA和PSAD在HGPIN与PCa组间差异有统计学意义(P＜0.05).HGPIN的ROC曲线中,血清PSA和PSAD的曲线下面积分别为0.6281和0.5919,两者比较差异无统计学意义(P＞0.05). 结论 血清PSA和PSAD在HGPIN的早期预测中有诊断价值；PSAD有利于在PSA和f/t正常时鉴别HGPIN与PCa；LGPIN的临床特点接近于BPH,HGPIN则倾向于PCa.
目的 探討血清總PSA(t-PSA)、血清遊離PSA與總PSA比值(f/t)、前列腺體積(PV)及PSA密度(PSAD)與前列腺上皮內瘤(prostatic intraepithelial neoplasia,PIN)的相關性及臨床意義.方法 收集我院2004年1月至2009年12月PIN患者165例,其中低級彆PIN( low grade prostatic intraepithelial neoplasia,LGPIN)31例,高級彆PIN(high grade prostatic intraepithelial neoplasia,HGPIN)134例；以病理確診的BPH患者252例和前列腺癌(prostate cancer,PCa)患者49例為對照組.BPH、LGPIN、HGPIN、PCa組年齡分彆為(70.13±0.43)、(70.97±1.28)、(70.74±0.64)、(70.37±1.40)歲,IPSS分彆為20.20±0.88、14.71±3.42、20.19±1.24、19.27±2.73,PV分彆為(58.07±3.58)、(56.01±7.52)、(60.74±4.81)、(47.56±6.54)ml.分析比較4組間PSA、f/t、PSAD等的相關性和差異. 結果 4組年齡、IPSS和PV比較差異均無統計學意義(P＞0.05).BPH、LGPIN、HGPIN、PCa組PSA值分彆為(5.65±0.38)、(5.86 ±0.81)、(8,91±0.71)、(13.80±1.83) μg/L,f/t平均值分彆為0.26 ±0.01、0.24±0.02、0.22±0.01、0.17±0.01；PSAD值分彆為(0.11±0.01)、(0.10±0.02)、(0.19±0.03)、(0.48 ±0.12)μg/(L·cm3).PSA、f/t和PSAD在LGPIN和HGPIN組間差異無統計學意義(P＞0.05),在LGPlN和BPH組間差異無統計學意義(P＞0.05),在LGPIN和PCa組間差異有統計學意義(P＜0.05),在HGPIN和BPH組間差異有統計學意義(P ＜0.05)；PSA和PSAD在HGPIN與PCa組間差異有統計學意義(P＜0.05).HGPIN的ROC麯線中,血清PSA和PSAD的麯線下麵積分彆為0.6281和0.5919,兩者比較差異無統計學意義(P＞0.05). 結論 血清PSA和PSAD在HGPIN的早期預測中有診斷價值；PSAD有利于在PSA和f/t正常時鑒彆HGPIN與PCa；LGPIN的臨床特點接近于BPH,HGPIN則傾嚮于PCa.
목적 탐토혈청총PSA(t-PSA)、혈청유리PSA여총PSA비치(f/t)、전렬선체적(PV)급PSA밀도(PSAD)여전렬선상피내류(prostatic intraepithelial neoplasia,PIN)적상관성급림상의의.방법 수집아원2004년1월지2009년12월PIN환자165례,기중저급별PIN( low grade prostatic intraepithelial neoplasia,LGPIN)31례,고급별PIN(high grade prostatic intraepithelial neoplasia,HGPIN)134례；이병리학진적BPH환자252례화전렬선암(prostate cancer,PCa)환자49례위대조조.BPH、LGPIN、HGPIN、PCa조년령분별위(70.13±0.43)、(70.97±1.28)、(70.74±0.64)、(70.37±1.40)세,IPSS분별위20.20±0.88、14.71±3.42、20.19±1.24、19.27±2.73,PV분별위(58.07±3.58)、(56.01±7.52)、(60.74±4.81)、(47.56±6.54)ml.분석비교4조간PSA、f/t、PSAD등적상관성화차이. 결과 4조년령、IPSS화PV비교차이균무통계학의의(P＞0.05).BPH、LGPIN、HGPIN、PCa조PSA치분별위(5.65±0.38)、(5.86 ±0.81)、(8,91±0.71)、(13.80±1.83) μg/L,f/t평균치분별위0.26 ±0.01、0.24±0.02、0.22±0.01、0.17±0.01；PSAD치분별위(0.11±0.01)、(0.10±0.02)、(0.19±0.03)、(0.48 ±0.12)μg/(L·cm3).PSA、f/t화PSAD재LGPIN화HGPIN조간차이무통계학의의(P＞0.05),재LGPlN화BPH조간차이무통계학의의(P＞0.05),재LGPIN화PCa조간차이유통계학의의(P＜0.05),재HGPIN화BPH조간차이유통계학의의(P ＜0.05)；PSA화PSAD재HGPIN여PCa조간차이유통계학의의(P＜0.05).HGPIN적ROC곡선중,혈청PSA화PSAD적곡선하면적분별위0.6281화0.5919,량자비교차이무통계학의의(P＞0.05). 결론 혈청PSA화PSAD재HGPIN적조기예측중유진단개치；PSAD유리우재PSA화f/t정상시감별HGPIN여PCa；LGPIN적림상특점접근우BPH,HGPIN칙경향우PCa.
Objective To investigate the serum prostate specific antigen tPSA),ratio of serum free PSA to total PSA (f/t),prostate volume (PV) and prostate specific antigen density (PSAD),their correlation with prostatic intraepithelial neoplasia (PIN) and their clinical diagnostic significance. Methods Retrospectively evaluate 165 cases of patients with PIN ( including 31 cases of LGPIN,134 cases of HGPIN),which confirmed by pathology,and 252 cases of benign prostatic hyperplasia (BPH),49 patients with prostate cancer (PCa),both diagnosed by pathology,as control.The average age of BPH,LGPIN,HGPIN,PCa groups were 70.13 ± 0.43,70.97 ± 1.28,70.74 ± 0.64,70.37 ± 1.40,the International Prostate Symptom Score (IPSS) were 20.20 ± 0.88,14.71 ± 3.42,20.19 ± 1.239,19.27 ± 2.73,and the PV were 58.07 ± 3.58,56.01 ± 7.52,60.74 ± 4.81,47.56 ± 6.54,respectively.The data of PSA,f/t,PV and PSAD were analyzed and compared within the four groups. Results Age,IPSS score and PV had no significant difference among the four groups (P ＞ 0.05).The PSA level of BPH,LGPIN,HGPIN,PCa groups were 5.65 ±0.38,5.86 ±0.81,8.91 ±0.71,13.80 ±1.83,the f/t ratio were 0.26 ±0.01,0.24 ±0.02,0.22 ±0.01,0.167 ± 0.01,and the PSAD level were 0.11 ± 0.01,0.10 ± 0.02,0.19 ±0.03,0.48 ±0.12,respectively.PSA,f/t and PSAD were not significantly different between HGPIN and LGPIN ( P ＞ 0.05 ),and likewise between LGPIN and BPH patients ( P ＞ 0.05 ).PSA,f/t and PSAD were significantly different between LGPIN and PCa patients ( P ＜ 0.05),and likewise between HGPIN and BPH patients (P ＜ 0.05 ).PSA and PSAD were significantly different between HGPIN and PCa (P ＜ 0.05 ).The areas under the ROC curve of PSA and PSAD of HGPIN were 0.6281 (P ＜0.01 ) and 0.5919 (P ＜0.05).Conclusions PSA and PSAD are correlated with HGP1N and can predict the existence of HGPIN early;PSAD can identify HGPIN and PCa,when PSA and f/t are normal.The clinical features of LGPIN are similar to BPH,and HGPIN is easy to develop to PCa.
