前列腺体积和无症状性前列腺组织炎症对血清PSA的影响

Effect of prostate volume and prostatic tissue inflammation on serum prostate-specific antigen

目的探讨前列腺体积和无症状性前列腺组织炎症对血清前列腺特异性抗原(PSA)的影响。方法对因血清PSA增高(>4.00ng/ml)行前列腺穿刺活检但结果为良性前列腺增生(BPH)的患者进行分组,穿刺组织中无炎症存在,则为BPH组;穿刺组织中有炎症存在,则再分为急性炎症组和慢性炎症组;共126例患者入选,其中BPH组47例,急性炎症组45例,慢性炎症组34例。经直肠B超测量所有患者的前列腺体积;分析前列腺体积及炎症的类型对血清PSA的影响。结果三组患者的血清PSA分别为(5.76±3.21)、(8.67±2.92)、(5.54±3.01)ng/ml,急性炎症组血清PSA较BPH组和慢性炎症组明显增高(P<0.01)。三组患者的前列腺体积分别为(41.2±14.6)、(31.1±11.3)、(39.6±9.8)ml。前列腺体积可明显影响血清PSA(P<0.01),且血清PSA与前列腺体积呈正相关(r=0.613,P<0.01)。结论前列腺体积的增大和前列腺穿刺活检组织中的急性炎症均可使血清PSA明显升高,评估前列腺穿刺活检(重复活检)指征时应予重视。

Objective To explore the effect of prostate volume and the prostatic tissue inflammation on serum prostate - specific antigen（PSA）. Methods The patients of benign prostatic hyperplasia （BPH） with abnormal serum PSA （ 〉4.00 ng/ml） were divided into BPH group （without inflammation）, acute inflammation group and chronic inflammation group. The diagnosis was confirmed by transrectal- ultrasound guided needle biopsies. Prostate volumes were measured in all patients by the transrectal - ultrasound. A total of 126 patients were included in this study. The biopsy results showed 47 patients in BPH group, 45 patients in acute inflammation group and 34 patients in chronic inflammation group. Results The serum PSA value in the BPH group, acute inflammation group and chronic inflammation group were （5.76±3.21）,（ 8.67 ±2.92 ） and （5.54±3.01） ng/ml respectively. The serum PSA value in acute inflammation group was much higher than that of BPH group and chronic inflammation group（ P 〈0.01 ）. The prostate volume in the BPH group, acute inflammation group and chronic inflammation group was （41.2 ±14.6）, （31.1 ±11.3） and （39.6±9.8）ml separately. The serum PSA value could be effected significantly by the prostate volume （ P 〈 0.01 ） with the positive relation （ r = 0. 613, P 〈0.01 ）. Condusions The enlarged prostate volume and prostatic tissue acute inflammation can effect the serum PSA value significantly. They shall be take into account when assess the indication of biopsy.