代谢综合征与前列腺穿刺阳性率的相关性分析

Relationship of metabolic syndrome and positive rate of prostate biopsy

目的：分析代谢综合征（MS）与前列腺穿刺阳性率的关系，并探讨代谢综合征与前列腺癌发病率的相关性。方法依据中国泌尿外科疾病诊疗指南，确定前列腺穿刺活检对象。并参照代谢综合征CDS诊断标准，将患者分为代谢综合征组（MS）和非代谢综合征组（NMS）。两组均在B超引导下行经直肠前列腺穿刺活检术。比较两组间前列腺特异抗原、前列腺体积、前列腺穿刺阳性率和病理结果，对所得数据进行统计学分析。结果前列腺穿刺活检病例111例，MS组41例（36.9%），NMS组70例（63.1%）。MS组穿刺阳性率为61.0%（25/41），NMS组穿刺阳性率为32.9%（23/70）。两组穿刺阳性率比较有统计学意义（P＜0.05），MS组前列腺穿刺阳性率高于NMS组。MS组高分级前列腺癌发病率48.0%（12/25），NMS组高分级前列腺癌发病率为17.4%（4/23），MS组高分级前列腺癌的发病率有增高趋势，两组相比差异有统计学意义（P ＜0.05）。Logistics回归分析提示高血压、肥胖及HDL是影响前列腺穿刺阳性率的独立因素。结论 MS患者前列腺穿刺阳性率高于NMS患者，且MS增加高分级前列腺癌发病风险。

Objective To analyze the relationship of metabolic syndrome with cancer detection in prostate biopsy, and investigate the correlation between metabolic syndrome and the ocurrence of prostate cancer. Methods A total of 111 patients undergoing a prostate biopsy were divided into metabolic syndrome and non-metabolic syndrome according to CDS diagnostic criteria. The differences of prostate specific antigen （PSA） level, prostate volume, prostate cancer detection rate and pathological result between two groups were analyzed by Logistics regression analysis. Results The MS group had a significantly higher rate of cancer detection than the non-MS group （63.1%vs36.9%, P〈0.05）,andthe rate of high-grade prostatic cancer in MS group was significantly higher than the non-MS group（48.0%vs17.4%,P〈0.05）. Logistics regression analysis showed that hypertension, obesity, and HDL had a positive correlation with cancer detection on biopsy. Conclusion Patients with MS had a significant higher positive rate of prostate biopsy than those without MS, and the metabolic syndrome increases the incidence risk of advanced stage prostate cancer.