tPSA、fPSA和外周血中性粒细胞在前列腺癌诊断中的应用研究

Levels of tPSA and fPSA and count of peripheral blood neutrophils in the diagnosis of prostate cancer

目的:探讨总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)和外周血中性粒细胞计数(Neut#)联合检测在前列腺癌(PCa)诊断中的价值。方法:869例2018年8月至2021年12月到本院就诊或体检的PCa、BPH患者及健康男性,分为PCa、BPH、健康对照(HC)组。检测其血清中tPSA、fPSA的含量及Neut#。应用Logistic回归结合ROC曲线、Spearman相关分析及非参数检验方法判断相关指标及联合检测指标的诊断价值。结果:PCa、BPH和HC组任意两组间的tPSA、fPSA、Neut#均呈现显著性差异(P<0.05)。tPSA、fPSA和Neut#的联合指标N的诊断价值优于单项指标。Gleason评分与tPSA、fPSA、N之间呈现显著正相关关系(相关系数分别为0.184、0.245、0.166,P均<0.05),与Neut#之间呈现显著负相关关系(相关系数为-0.168,P<0.05)。不同Gleason评分组别tPSA、fPSA、Neut#、N呈现出显著性差异(P<0.05)。结论:tPSA、fPSA、Neut#及联合检测指标提高了对PCa及恶性程度的判断能力,可作为PCa辅助诊断方法应用于临床。

Objective:To investigate the value of combined detection of tPSA,fPSA and peripheral blood neutrophil count(Neut#)in the diagnosis of PCa.Methods:This study included 238 cases of PCa,328 cases of BPH and 303 normal men as healthy controls present at our hospital for medical or physical examination from August 2018 to December 2021.We detected the levels of serum tPSA and fPSA and Neut#of the subjects,and assessed the value of the combined detection in the diagnosis of PCa using logistic regression analysis,ROC curves,Pearman correlation analysis and nonparametric test.Results:There were significant differences in the tPSA and fPSA levels and Neut#between any two of the PCa,BPH and healthy control groups(P<0.05).The index N of the combined detection of tPSA,fPSA and Neut#showed an evidently higher diagnostic value than that of any single-item detection.The Gleason scores of the subjects were correlated positively with the tPSA and fPSA levels and index N,with the correlation coefficients of 0.184,0.245 and 0.166 respectively,P<0.05,and negatively with the Neut#,with the correlation coefficient of-0.168,P<0.05.Statistically significant differences were observed in the tPSA and fPSA levels,Neut#and index N in those with different Gleason scores(P<0.05).Conclusion:The combined detection of tPSA,fPSA and Neut#improves the diagnosis of PCa and can be applied clinically as an auxiliary diagnostic method.