“诊断性”TURP在BPH伴血清PSA异常患者中的应用价值

The Role of diagnostic TURP in patients with elevated serum PSA levels BPH

目的:探讨"诊断性"TURP在BPH伴血清PSA异常患者中的应用价值及意义。方法:对BPH伴血清PSA异常患者行"诊断性"TURP,然后对手术切除的前列腺组织行病理检查,按照病理诊断结果分为PCa组和BPH组,分别评估PCa组患者的临床分期及Gleason评分和BPH组患者TURP术后3个月、6个月、1年及随访结束时血清PSA、IPSS评分、生活质量等。结果:87例BPH伴血清PSA异常者行"诊断性"TURP,病理诊断为PCa 5例,Gleason评分5~8分,肿瘤分期T1a^T2a,行PCa根治性切除术;病理诊断为BPH 82例,出院后均随访2~4年,其中血清PSA恢复正常者77例,显著下降者3例,持续异常者2例,IPSS评分均有明显降低。结论:对血清PSA异常患者,"诊断性"TURP可有助于诊断PCa并对下尿路症状的改善和血清PSA的正常化具重要作用。

Objective： To evaluate the value and significance of diagnostic transurethral resection of the pros- tate（TURP） in the patients with persistently abnormal serum PSA levels. Methods： BPH patients with elevated serum PSA levels （〉4 μg/L） underwent TURP. According to pathological examination of prostate tissue re- moved in TURP, we divided the patients into the PCa group and BPH group. Gleason score, clinical stage were e- valuated for PCa patients, serum PSA testing and the International Prostate Symptom Score （IPSS） etc were eval- uated for BPH patients every three months, six months and one year respectively. Results： Of 87 patients, 82 ca- ses were diagnosed as 13PH by pathological examination postoperatively, 5 cases were PCa, Gleason score 5-8, tumor stage T1a-T2a and radical prostatectomy was done. Followed up 2-4 years, 77 patients have normal serum PSA, 3 serum PSA reduced greatly, 2 persistently abnormal serum PSA, IPSS for all patients reduced greatly. Conclusion： Diagnostic TURP can be used as an important method in the diagnosis of patients with elevated serum PSA levels. Also the lower urinary tract symptoms could be relieved by TURP and serum PSA could recover to normal level.