直肠指检对PSA、F-PSA影响的研究

The effect of digital rectal examination on PSA and F-PSA levels

目的 :探讨直肠指检对前列腺特异抗原 (PSA)、游离前列腺特异抗原 (F PSA)的影响及其持续的时间。方法 :本组 5 1例 ,每例分别于直肠指检前、直肠指检后 1天、1周、4周抽取静脉血 2ml,采用放射免疫法测定PSA、F PSA。结果 :本组 5 1例直肠指检前血清PSA值为 0 .18～ 9.4μg/L ,平均2 .5 8± 2 .17μg/L ,F PSA值为0 .0 9～ 1.89μg/L ,平均0 .5 3± 0 .42 μg/L ,F/T比值为0 .0 6～ 0 .83,平均 0 .2 6± 0 .15 ;直肠指检后 1天、1周及 4周 ,PSA、F PSA及F/T比值虽然有所增高 ,但经统计学处理均无显著性意义。直肠指检前PSA <4.0 μg/L者 38例 ,PSA值平均为 1.5 0± 0 .92 μg/L ,PSA值≥4.0 μg/L者 13例 ,PSA值平均为5 .76± 1.5 4μg/L ;直肠指检后 1天、1周、4周 ,PSA、F PSA及F/T比值与检查前相比仍然没有统计学意义。结论 :只要检查过程中避免对前列腺作出强烈的挤压 ,常规的直肠指检对PSA、F PSA的影响极其轻微 ,且时间较短。

Purpose:To determine the effect of digital rectal examination on PSA and F PSA levels.Method: A total of 51 subjects were studied. Total and free PSA was measured immediately before, and 1 day, 1 week, and 4 week after digital rectal examination (DRE). Results:The mean concentration of PSA, F PSA and F/T ratio before DRE were 2.58 ± 2.17 μg/L, 0.53 ± 0.42 μg/L and 0.26 ± 0.15 respectively. Overall, there was a slight but not statistically significant increase in PSA, F PSA levels and F/T ratio after DRE. The same results could also be observed when stratified by initial PSA levels. Conclusions:Although there is a slight and temporary increase in serum PSA, F PSA levels and F/T ratio after DRE, this is not clinically significant unless a vigorous prostate massage was done.