高级别前列腺上皮内瘤患者血浆纤维蛋白原水平及临床意义

Clinical Significance of Plasma Fibrinogen in Patients with High-grade Prostatic Intraepithelial Neoplasia

目的:探讨高级别前列腺上皮内瘤(HGPIN)患者血浆纤维蛋白原(Fib)水平变化及其临床意义。方法:111例良性前列腺增生(BPH)患者(BPH组)、55例HGPIN患者(HGPIN组)、61例前列腺癌(PCa)患者(PCa组),采用免疫比浊法检测各组血浆Fib浓度,采用双夹心免疫法及化学发光法检测HGPIN组血清前列腺特异性抗原(PSA,包括tPSA和cPSA)水平,统计学分析各组Fib水平差异及HGPIN组Fib与PSA的相关性。以病理诊断为金标准、评价Fib对HGPIN的诊断价值。结果:三组患者血浆Fib水平中位数分别为2.55g/L,3.22g/L和4.09g/L,HGPIN组和PCa组显著高于BPH组(P<0.01),PCa组又高于HGPIN组,差异均有统计学意义(P<0.01)。HGPIN组血浆Fib水平与血清tPSA、cPSA水平呈显著正相关(r=0.304、0.334,P<0.05)。血浆Fib诊断HGPIN的敏感度为23.64%,特异度为93.69%,误诊率为6.31%,漏诊率为76.36%。结论:HGPIN患者血浆Fib水平升高,可以作为HGPIN患者辅助诊断的参考指标。

Objective： To detect the plasma level of fibrinogen （Fib） in patients with high-grade prostatic intraepithelial neoplasia（HGPIN） and its clinical significance. Method： The study included 111 cases of benign prostatic hyperplasia （BPH） patients, 55 patients with HGPIN and 61 cases of patients with prostate cancer （Pea）. The concentration of plasma Fib was detected using immunoturbidimetry and serum prostate specific antigen （PSA） including tPSA and cPSA were detected using double sandwich immune method and chemical luminescence method. Then analysis the difference of Fib in each group and the correlation of Fib and PSA in HGPIN group with statistical method. Results： The median of the plasma level of Fib in group BPH, HGPIN and PCa were 2.55g/L,3.22g/L,4. 09g/L. The plasma Fib was significantly increased in patients with HGPIN and PCa compared to patients with BPH （P〈0.01）. The plasma Fib was higher in patients with PCa than those with HGPIN（P〈0.01）. The level of plasma Fib was significant positively correlated with serum PSA in HGPIN patients （P〈0.05）. When plasma Fib was used to diagnose HGPIN, the sensitivity, specificity, mistake diagnostic rate and omission diagnostic rate were 23. 64 %,93. 69 %, 6. 31 %, 76.36 %. Conclusion： Plasma Fib is significantly increased in patients with HGPIN. Thus, it might be a diagnostic indicator for HGPIN patients.