中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2015年
5期
1190-1192
,共3页
前列腺癌%前列腺健康指数%前列腺特异抗原
前列腺癌%前列腺健康指數%前列腺特異抗原
전렬선암%전렬선건강지수%전렬선특이항원
Prostate cancer%Prostate health index%Prostate specific antigen
目的 探讨前列腺健康指数(PHI)对血清前列腺特异抗原(PSA)在4～ 10 μg/L、直肠指诊阴性(-)患者前列腺癌的诊断价值.方法 选择101例血清PSA在4～ 10 μg/L、直肠指诊(-)并接受经直肠B超引导下前列腺穿刺活检的老年男性的临床资料,其中前列腺癌16例、良性病变85例.检测血清总PSA(tPSA)、游离PSA(fPSA)和前列腺特异性抗原前体(p2 PSA),分别计算游离PSA百分比(％ fPSA)、％p2PSA和PHI,以前列腺穿刺活检作为前列腺癌确诊依据,建立tPSA、％fPSA、p2PSA、％p2PSA和PHI的受试者工作特征曲线,计算曲线下面积(AUC),分析tPSA、％fPSA、p2PSA、％p2PSA和PHI诊断前列腺癌的价值以及PHI预判前列腺癌侵袭性的价值.结果 前列腺癌组的tPSA、fPSA、p2PSA、％fPSA、％p2PSA和PHI均值分别为6.94、1.27 μg/L、21.49 ng/L、18.71％、1.59％、41.51,区别于非前列腺癌组的6.68、1.34 μg/L、13.37 ng/L、20.42％、1.05％、27.18;PHI、％p2PSA、p2PSA、％fPSA和tPSA的诊断前列腺癌的AUC分别为0.777、0.769、0.681、0.590、0.580.前列腺癌组中Gleason评分≥7组PHI均值明显大于Gleason评分≤6组PHI均值,差异有统计学意义(P＜0.05).结论 PHI能进一步提高直肠指诊(-)、血清PSA在4～10 μg/L患者的前列腺癌诊断准确性,具有比％ p2PSA、p2PSA、％fPSA、tPSA更高的诊断价值,而且PHI值与前列腺癌侵袭性呈正相关.
目的 探討前列腺健康指數(PHI)對血清前列腺特異抗原(PSA)在4～ 10 μg/L、直腸指診陰性(-)患者前列腺癌的診斷價值.方法 選擇101例血清PSA在4～ 10 μg/L、直腸指診(-)併接受經直腸B超引導下前列腺穿刺活檢的老年男性的臨床資料,其中前列腺癌16例、良性病變85例.檢測血清總PSA(tPSA)、遊離PSA(fPSA)和前列腺特異性抗原前體(p2 PSA),分彆計算遊離PSA百分比(％ fPSA)、％p2PSA和PHI,以前列腺穿刺活檢作為前列腺癌確診依據,建立tPSA、％fPSA、p2PSA、％p2PSA和PHI的受試者工作特徵麯線,計算麯線下麵積(AUC),分析tPSA、％fPSA、p2PSA、％p2PSA和PHI診斷前列腺癌的價值以及PHI預判前列腺癌侵襲性的價值.結果 前列腺癌組的tPSA、fPSA、p2PSA、％fPSA、％p2PSA和PHI均值分彆為6.94、1.27 μg/L、21.49 ng/L、18.71％、1.59％、41.51,區彆于非前列腺癌組的6.68、1.34 μg/L、13.37 ng/L、20.42％、1.05％、27.18;PHI、％p2PSA、p2PSA、％fPSA和tPSA的診斷前列腺癌的AUC分彆為0.777、0.769、0.681、0.590、0.580.前列腺癌組中Gleason評分≥7組PHI均值明顯大于Gleason評分≤6組PHI均值,差異有統計學意義(P＜0.05).結論 PHI能進一步提高直腸指診(-)、血清PSA在4～10 μg/L患者的前列腺癌診斷準確性,具有比％ p2PSA、p2PSA、％fPSA、tPSA更高的診斷價值,而且PHI值與前列腺癌侵襲性呈正相關.
목적 탐토전렬선건강지수(PHI)대혈청전렬선특이항원(PSA)재4～ 10 μg/L、직장지진음성(-)환자전렬선암적진단개치.방법 선택101례혈청PSA재4～ 10 μg/L、직장지진(-)병접수경직장B초인도하전렬선천자활검적노년남성적림상자료,기중전렬선암16례、량성병변85례.검측혈청총PSA(tPSA)、유리PSA(fPSA)화전렬선특이성항원전체(p2 PSA),분별계산유리PSA백분비(％ fPSA)、％p2PSA화PHI,이전렬선천자활검작위전렬선암학진의거,건립tPSA、％fPSA、p2PSA、％p2PSA화PHI적수시자공작특정곡선,계산곡선하면적(AUC),분석tPSA、％fPSA、p2PSA、％p2PSA화PHI진단전렬선암적개치이급PHI예판전렬선암침습성적개치.결과 전렬선암조적tPSA、fPSA、p2PSA、％fPSA、％p2PSA화PHI균치분별위6.94、1.27 μg/L、21.49 ng/L、18.71％、1.59％、41.51,구별우비전렬선암조적6.68、1.34 μg/L、13.37 ng/L、20.42％、1.05％、27.18;PHI、％p2PSA、p2PSA、％fPSA화tPSA적진단전렬선암적AUC분별위0.777、0.769、0.681、0.590、0.580.전렬선암조중Gleason평분≥7조PHI균치명현대우Gleason평분≤6조PHI균치,차이유통계학의의(P＜0.05).결론 PHI능진일보제고직장지진(-)、혈청PSA재4～10 μg/L환자적전렬선암진단준학성,구유비％ p2PSA、p2PSA、％fPSA、tPSA경고적진단개치,이차PHI치여전렬선암침습성정정상관.
Objective To investigate the role of prostate health index (PHI) in prostate cancer detection with a serum prostate specific antigen (PSA) level of 4-10 μg/L and negative digital rectum examination (DRE).Methods In a prospective study from October 2013 to October 2014,the clinical data of 101 old men were analyzed.All the 101 cases were DRE (-),had the serum PSA level of 4-10 μg/L and received prostate biopsy guided by transrectal ultrasound,including 16 cases of prostate cancer and 85 cases of benign prostate diseases.Serum total PSA (tPSA),free PSA (fPSA) and proPSA (p2PSA) were detected and ％ fPSA,％ p2PSA and PHI were calculated.Using prostate biopsy for the definite diagnosis of prostate cancer,receiver operating characteristic curves (ROC) of PHI,％ p2PSA,p2PSA,％ fPSA and tPSA were established and the areas under the curve (AUC) were calculated.The diagnostic value of PHI,％ p2PSA,p2PSA,％ fPSA and tPSA,and the value of PHI for predicting aggressive prostate cancer were analyzed.Results In the prostate cancer group,average tPSA,fPSA,p2PSA,％ fPSA,％ p2PSA and PHI were 6.94,1.27 μg/L,21.49 ng/L,18.71％,1.59％ and 41.51 respectively,which were different from those in the non-cancer group (6.68,1.34 μg/L,13.37 ng/L,20.42％,1.05％ and 27.18).The AUCs of PHI,％ p2PSA,％ fPSA and tPSA for diagnosis of prostate cancer were 0.777,0.769,0.681,0.590 and 0.580 respectively.In the prostate cancer group with Gleason score ≥7,the PHI value was higher than that of the group with Gleason score ≤6 (P ＜0.05).Conclusion PHI can improve the diagnosis accuracy of prostate cancer in patients with the serum PSA level of 4-10 μg/L and DRE (-).PHI has the diagnostic value better than tPSA,％ fPSA,p2PSA or ％p2PSA.PHI value is positively associated with the aggressive prostate cancer.
