应用前列腺特异性抗原筛查前列腺癌的意义

The significance of prostate specific antigen in screening of pratate cancer

目的:探讨应用血清前列腺特异性抗原(PSA)行前列腺癌筛查的临床意义。方法:对4 848名50岁以上男性常规体检检测血清PSA,发现前列腺癌患者33例(筛查组),与同期临床诊治的28例前腺癌患者(临床组)进行对比,比较两组年龄分布、PSA值、临床分期、G leason评分和治疗方法。结果:筛查人群中PSA阳性(PSA≥4ng/m l)者461名,检出率为9.5%,其中确诊前列腺癌者33例,占筛查者的6.8‰。筛查组年龄为(73.2±8.0)岁,与临床组比较差异无显著性意义;筛查组PSA≥20 ng/m l者占42.4%,临床组占71.5%,两组比较差异有显著性意义;筛查组中(A+B)期占69.7%,临床组中(A+B)期占35.7%,P<0.01;筛查组接受根治性前列腺切除者16例(48.5%),临床组6例(21.4%)。结论:应用血清PSA筛查能早期诊断前列腺癌,可为患者提供更佳的治疗机会。

Objective ： To investigate the role of prostate specific antigen （PSA） in screening for prostate cancer. Methods ： The serum PSA of 4 848 males over 50-years old for serum PSA was evaluated, respectively out of them 33 cases diagnosed as prostate cancer（ screening group） were compared in terms of age distribution, level of PSA, clinical stages, Gleason score and treatment modalities with 28 patients in our hospital （clinical group）. Results： In the screening group, the positive percentage account for 9.5% （PSA≥4 ng/ml） and the PCa positive rate was 6.8‰（33/4 848）. The average age of the patients （73.2 ±8.0） was insignificant different between these two groups. The percentage of the cases beyond 20 ng/ml PSA in the screening group was significantly lower than that in clinical group, with 42.4% and 71.5% respectively. Furthermore, the cases with clinical stage A＋B accounted for 69.7% in the screening group, while it was 35.7% in the clinical group （P 〈 0.01 ）. Finally, 16 cases in screening group （48.5 % ） and 6 cases in clinical group （21.4%） were performed radical prostatectomy. Conclusion： Screening for PSA is valuable to the early diagnosis of prostate cancer, and hence gives us an oppprtunity for the early treatment.