前列腺体积和年龄因素对前列腺特异性抗原等指标在前列腺癌筛选中的影响

Effect of prostate volume and patients' age on PSA and other indexs in screening prostate cancer

目的:探讨前列腺特异抗原(prostate specific antigen,PSA)、前列腺特异性抗原密度(prostate specific antigen density,PSAD)及移行带前列腺特异性抗原密度(pros-tate specific antigen density of transition zone,PSAD-TZ)用于前列腺癌筛选时前列腺体积和患者年龄因素对其的影响。方法:回顾性分析因PSA升高和(或)直肠指检异常疑诊前列腺癌而进行直肠前列腺穿刺活组织检查(活检)的295例男性患者的临床资料,根据活检结果分为BPH组(193例)和前列腺癌组(102例),比较2组中不同前列腺体积以及不同年龄段的PSA、PSAD及PSAD-TZ水平。结果:当前列腺体积小于或等于50mL时,BPH组的PSA、PS-AD及PSAD-TZ值与前列腺癌组比较差异均有统计学意义(P<0.01);当前列腺体积大于50mL时,2组的PSA值比较差异无统计学意义(P>0.05),但PSAD及PSAD-TZ值比较差异有统计学意义(均为P<0.01)。2组的PSA值随着年龄的增加而升高(均为P<0.01)。在50～59岁者和60～69岁者中,2组的PSAD及PSAD-TZ值比较差异均有统计学意义(P<0.05～0.01);在70～79岁者中,2组的PSAD及PSA-TZ值比较差异无统计学意义。结论:当前列腺体积小于或等于50mL时,检测PSA、PSAD及PSAD-TZ值对前列腺癌的筛选有重要意义,而前列腺体积大于50mL时,需结合PSAD、PSAD-TZ值以及患者的年龄作综合分析。

Objective： To study the influence of prostate volume （PV） and patients＇ age on prostate specific antigen（ PSA）, prostate specific antigen density（PSAD） and prostate specific antigen density of transition zone （PSAD-TZ） in screening prostate cancer. Methods： The clinical data of 295 male patients were restrospectively analyzed, which with elevated PSA and / or abnormal digital examination. Transrectal prostate biopsies were performed to diagnose prostate cancer. Based on the results of biopsy, two groups were defined： benign prostate hyperplasia（BPH） group（ 193 cases）and cancer group（ 102 cases）. PSA, PSAD, and PSAD-TZ were assessed according to different prostate volume and patients＇ age in two groups. Results： When prostate volume was ≤50 mL, statistically significant differences in PSA, PSAD and PSAD-TZ were noted between BPH group and cancer group（P 〈 0.01）. When prostate volume was 〉50 mL, no significant difference in PSA （P 〉0. 05） was found, but there were significant differences in PSAD and PSAD-TZ（P 〈0. 01 ）between the two groups. PSA values increased with agein both groups（ P 〈0. 01 ）. Significant differences in PSAD and PSAD-TZ were noted in age group from 50 to 59 year and age group from 60 to 69 year（P 〈0. 05 -0. 01 ）, but no significant difference was found in age group from 70 to 79 year. Conclusion： When prostate volume is ≤50 mL, detection of PSA, PSAD and PSAD-TZ is significant in screening prostate cancer. However, when prostate volume is 〉 50 mL, age should be taken into consideration for PSAD and PSAD-TZ in screening prostate cancer.