健康男性前列腺健康指数各年龄段分布曲线特征及临床意义

An initial study on male age-related distribution curves characteristics of prostate health index in a health survey report

目的综合对比前列腺特异抗原（PSA）各指标,探讨健康男性各年龄段前列腺健康指数（PHI）指标潜在价值及意义。方法对238名10～90岁年龄段马鞍山地区健康男性统一检测tPSA、fPSA、p2PSA等指标,按每10岁一组共分为8组,分别计算各组均值及其95%可信区间（CI）,综合对比tPSA、fPSA、%fPSA、p2PSA、%p2PSA及PHI指标,绘制各指标年龄相关分布曲线并统计分析曲线特征。结果与其他曲线趋势不同,PHI指标终生随年龄变化特征相当显著：PHI曲线在10～29岁期间相对平稳,但随后出现2个高峰和1个低谷,分别为青春期高峰于30～39岁,PHI=31.83±10.29（95%CI 10.29～53.37）;老年期最高峰于60～69岁,PHI=42.85±9.06（95%CI 23.96～61.75）;中年期低谷于40～49岁,PHI=9.16±2.05（95%CI 8.19～16.76）。与fPSA终生持续缓慢上升不同,PHI与tPSA两者均在老年期转向下,但PHI转折点（60～69岁）较tPSA提早约10年。结论 PHI与年龄的相关性较PSA单一指标更敏感更超前,似能更准确反映前列腺总体功能在男性各年龄段的生理或病理动态变化特征。同时综合计算多指标而获取的PHI新指标,可能较以往PSA单一肿瘤标记物具有更多的潜在研究价值。

Objective To study some potential values of prostate health index （PHI） contrasted to conventional PSA tumor markers in health men. Methods 238 healthy men, aged from 10 to 90, were whole-randomly classified with every 10-year-old into 8 groups, tPSA, fPSA,%fPSA,p2PSA,%p2PSA and PHI levels in their sera were individually detected or calculated at same time, including the mean levels and the 95% confidence intervals （CO of each group. All data were analyzed by SPSS 19.0 statistics software, and their each age-related distribution curves were also comparatively studied. Results Compared to the other indexes, PHI curve had some apparently discriminate characteristics in male lifetime as follows. After a slightly fiat curve in 10-29 age areas, however, 2 mountain-peaks and 1 low-valley were subsequently arrived： the 1st peak located in 30-39 age points with PHI=31.83±10.29 （95% CI 10.29-53.37）; the 2nd peak showed in 60-69 age regions as PHI-42.85±9.06 （95% CI 23.96-61.75）; the unexpected valley appeared in 40-49 age ranges by PHI--9.16±2.05 （95% CI 8.19-16.76）. Moreover, after 60-69 years old, deviated from tPSA, PHI began to step into downward trend, when this turning-point was about 10 years earlier than that of tPSA. Conclusion Regarding to the relationships with ages, PHI had been discovered more sensitive values and earlier performance than tPSA to some extent in our study, which could be possibly speculated it to embody more male physiological and pathological features. Having added both PSA and p2PSA series into PHI formula, the new object of PHI might possibly have more potential clinical values than previous PSA markers, which would be worthy us to be further studied in future.