CAJ | 학술논문

目的调查中国前列腺癌联盟(Chinese Prostate Cancer Consortium,CPCC)成员医院开展前列腺穿刺活检的情况,探讨不同PSA值患者的前列腺癌检出率.方法回顾性收集2010年1月至2013年12月33家CPCC成员医院行前列腺穿刺活检患者的临床资料,包括患者血清PSA、前列腺体积、穿刺方式、穿刺针数等,所有信息采用EpiData Entry 3.1软件进行登记,分析行前列腺穿刺活检患者的临床特征及前列腺癌的检出率.结果共收集19 292例患者信息,其中22家医院的17 296例为连续收集病例,排除影响PSA的因素后,共13 904例纳入统计分析.前列腺体积为31.1～65.5ml,中位值44.0 ml.PSA ＜4.0、4.0～10.0、10.1～20.0、20.1～50.0、＞50.0 μg/L的患者分别为701例(5％)、4 124例(30％)、4 014例(29％)、2 587例(19％)、2 478例(18％).游离PSA比值9.0％～20.6％,中位值14.0％.采用超声引导下经直肠穿刺10 808例(78％),经会阴穿刺3 087例(22％).接受6、8、10、12针及饱和穿刺的患者分别为1 436例(10％)、2 640例(19％)、3 920例(28％)、4 989例(36％)和607例(4％),312例(2％)接受＜6针的非系统穿刺.本组13 904例的穿刺阳性率为44％(6 123/13 904),其中PSA4.1～10.0、10.1～20.0 μg/L患者的穿刺阳性率分别为26％和35％.阳性患者中,Gleason评分＜7分1 295例(21％),(3+4)分1 164例(19％),(4+3)分1 155例(19％),≥8分2 371例(39％),未记录评分138例(2％).结论目前CPCC成员医院开展前列腺穿刺活检的主要方式是超声引导下经直肠穿刺,行前列腺穿刺活检患者具有年龄大、PSA高、前列腺体积小、Gleason评分高的特点.
목적 조사중국전렬선암련맹(Chinese Prostate Cancer Consortium,CPCC)성원의원개전전렬선천자활검적정황,탐토불동PSA치환자적전렬선암검출솔.방법 회고성수집2010년1월지2013년12월33가CPCC성원의원행전렬선천자활검환자적림상자료,포괄환자혈청PSA、전렬선체적、천자방식、천자침수등,소유신식채용EpiData Entry 3.1연건진행등기,분석행전렬선천자활검환자적림상특정급전렬선암적검출솔.결과 공수집19 292례환자신식,기중22가의원적17 296례위련속수집병례,배제영향PSA적인소후,공13 904례납입통계분석.전렬선체적위31.1～65.5ml,중위치44.0 ml.PSA ＜4.0、4.0～10.0、10.1～20.0、20.1～50.0、＞50.0 μg/L적환자분별위701례(5％)、4 124례(30％)、4 014례(29％)、2 587례(19％)、2 478례(18％).유리PSA비치9.0％～20.6％,중위치14.0％.채용초성인도하경직장천자10 808례(78％),경회음천자3 087례(22％).접수6、8、10、12침급포화천자적환자분별위1 436례(10％)、2 640례(19％)、3 920례(28％)、4 989례(36％)화607례(4％),312례(2％)접수＜6침적비계통천자.본조13 904례적천자양성솔위44％(6 123/13 904),기중PSA4.1～10.0、10.1～20.0 μg/L환자적천자양성솔분별위26％화35％.양성환자중,Gleason평분＜7분1 295례(21％),(3+4)분1 164례(19％),(4+3)분1 155례(19％),≥8분2 371례(39％),미기록평분138례(2％).결론 목전CPCC성원의원개전전렬선천자활검적주요방식시초성인도하경직장천자,행전렬선천자활검환자구유년령대、PSA고、전렬선체적소、Gleason평분고적특점.
Objective This multi-center study aims to investigate the PSA level,prostate volume,biopsy scheme and biopsy method of patients receiving prostate biopsy in Chinese Prostate Cancer Consortium (CPCC) hospitals and identify the detection rate of prostate cancer (PCa) in different PSA ranges in Chinese.Methods Detailed clinical information of consecutive patients underwent prostate biopsy in 33 CPCC hospitals were recorded with EpiData Entry 3.1.Those information included PSA level,prostate volume,biopsy scheme and biopsy method.All statistics analysis was performed with SPSS 17.0.T test was applied to compare age between different groups.Mann-Whitney U test was applied to compare PSA,prostate volume,and percent free PSA.Results A total of 19292 cases were collected.After excluding cases with factors that would influence PSA level,13904 cases from 22 hospitals were involved in further investigation.The medium volume of prostate was 44.0ml (range 31.1 ～ 65.5 ml).The distribution of patients in different PSA level included 701 cases (5％) in PSA ＜4.0,4124 cases (30％) in 4.0 ～ 10.0 μg/L phase,4014 cases (29％) in 10.1 ～ 20.0 μg/L phase,2587 cases (19％) in 20.1 ～50.0 μg/L phase,2478 cases (18％) in PSA ＞ 50.0 μg/L.There were 10808 cases who underwent transrectal ultrasound-guided prostate biopsy and 3087 cases who underwent transperineal biopsy.There were 312 (2％),1436(10％),2640(19％),3920(28％),4989(36％) and 607(4％) cases who underwent nonsystematic biopsy,6-,8-,10-,12-core and saturation biopsy,respectively.PCa detection rates were 44％,26％ and 35％ in all patients,patients with PSA 4.1-10.0 μg/L and 10.1-20.0 μg/L,respectively.The distribution of Gleason scores in those patients with positive biopsy included the 1295 cases (21％) with less than 7 scores,1164 cases (19％) with 3 +4 scores,1155 cases (19％) with 4 +3 scores,2371 cases with more than 8 scores and 138 cases (2％) with uncertain scores.Conclusion The most widely applied biopsy scheme in CPCC hospitals is transrectal ultrasound-guided biopsy.The PSA level of patients in CPCC hospitals is relatively high.The relationship between PSA level and PCa detection rate in Chinese population is different from reports in Western population.