前列腺腺癌患者血清PSA水平对Gleason评分的预测价值

The predictive value of serum PSA to Gleason score in patients with prostate adenocarcinoma

目的 探讨前列腺腺癌患者血清前列腺特异性抗原（PSA）水平对Gleason评分的预测价值.方法 研究血清PSA三种主要指标和Gleason分级主要指标均值;比较不同组别之间的差异,分析血清PSA与Gleason评分相关性,并观察血清总PSA（tP-SA）与Gleason评分之间变化趋势.结果 血清tPSA≤4.0、4.1～10.0、10.1～20.0、20.1～100.0、＞100.0 ng/mL组Gleason评分均值分别为6.31±0.47、6.66±0.89、7.04±1.11、7.56±1.03以及7.91±1.01;血清游离PSA（fPSA）≤1.0、1.1～10.0、＞10.0组Gleason评分均值分别为6.45±0.69、6.98±0.98以及7.75±1.05;血清总PSA（tPSA） t/fPSA≤0.16、0.17～0.50以及＞0.50组Gleason评分均值分别为6.72±0.88、7.45±1.04以及8.36±1.12.血清tPSA、fPSA以及fPSA/tPSA比值分别与Gleason评分、主要分级以及次要分级显著正相关;Gleason评分、主要分级以及次要分级均随血清tPSA、fPSA以及fPSA/tPSA逐渐增加而增加.结论 前列腺腺癌患者血清PSA对Gleason评分的具有预测价值;与fPSA和fPSA/tPSA比值相比,tPSA是最有预测价值的指标.

Objective To investigate the predictive value of the Gleason score to serum prostate specific antigen （PSA） in patients with prostate adenocarcinoma. Methods The mean level of 3 major indicators of serum PSA and Gleason score were studied and compared, the correlation between serum PSA and Gleason score was analyzed, and changes of serum PSA and G1- eason score were observed. Results When serum tPSAwas≤ 4.0, 4.1-10.0, 1-20.0, 20.1-100.0 and〉100.0 ng/mL, the average Gleason score was 6.31±0.47, 6.66±0.89, 7.04±1.11, 7.56±1.03 and 7.91±1.01. When serum fPSA was 1.0, 1.1-5.0, 〉5.0 ng/mL, the average Gleason score was 6.45± 0.69, 6.98± 0.98 and 7.75±1.05. When serum fPSA/tP- SA≤0.16, 0.17-0.50 and〉0.50, the average Gleason score was 6. 72± 0.88, 7.45±1.04 and 8.36±0.50. The serum t PSA, fPSA and fPSA/tPSA were significantly positively related to Gleason score, the primary grade and secondary grade. Oonclu- sions The serum PSA was useful to predict Gleason score in patients with prostate adenocarcinoma. Compared with fPSA and t/fPSA, tPSA is the most usefully predictive indicator.