前列腺穿刺活检患者红细胞分布宽度测定的临床意义

Clinical significance of red blood cell distribution width in the prostate biopsy patients

目的：探讨红细胞分布宽度（RDW）在前列腺穿刺活检患者中的临床意义。方法回顾性分析2010年10月至2015年1月我院793例经直肠前列腺穿刺活检患者的临床资料。年龄38-95岁，平均69岁。比较前列腺癌（ PCa）和良性前列腺增生（ BPH）患者间RDW的差异，分析RDW、前列腺特异性抗原（PSA）、血红蛋白（Hb）、血白细胞（WBC）、血小板（PLT）、甘油三酯（TG）和年龄等因素与前列腺穿刺阳性的关系。比较RDW在不同PSA值时对前列腺穿刺阳性的影响。分析RDW与 PCa 患者 PSA、Gleason 评分及临床分期的相关性。结果 PCa 患者 RDW [（13．38±1．11）％，359例]高于BPH患者[（12．75±0．62）％，434例]，差异有统计学意义（P＜0．001）。 RDW是前列腺穿刺阳性的独立影响因素，明显优于年龄和PSA （ OR值分别为2．440、1．061和1．017）。PSA＞20 ng／ml组患者ROC曲线下面积（ AUC）为0．730，明显高于其他PSA组。 PCa患者不同PSA组、Gleason评分组及临床分期之间的RDW差异均有统计学意义（ P＜0．05），随着疾病危险度越高， RDW值越大。结论 RDW在PCa患者中高于BPH患者。 RDW是前列腺穿刺阳性的独立影响因素，可用于预测前列腺穿刺结果，尤其是对PSA＞20 ng／ml的穿刺患者。 RDW分别与PSA、Gleason评分及临床分期呈正相关，RDW可用于评估前列腺癌危险程度。

Objective To assess the clinical significance of red blood cell distribution width （ RDW） in patients undergone prostate biopsy.Methods A total of 793 consecutive patients were enrolled, with 359 cases of prostate cancer （ PCa） and 434 cases of benign prostate hyperplasia （ BPH） diagnosed by pathological examination.The difference of RDW level between PCa and BPH patients was analyzed by T-test.Logistic regression was used to evaluate the contributed factors such as RDW, PSA, HB, WBC, PLT, TG and age.Areas under operating characteristic curves （ AUC） were used to compare the predictive power of RDW for the presence of PCa among different PSA level groups.The difference of RDW level was also analyzed in different groups divided by PSA, Gleason score and clinical stage respectively.Simple linear regression analysis was performed to explore the association of RDW with PSA, Gleason score and clinical stage.Results The means of RDW were （ 13.38 ±1.11 ）%in patients with PCa which were higher than those with BPH （12.75 ±0.62）%（P〈0.001）.The odds ratio of RDW was larger than that of PSA and age according to the Logistic regression analysis.AUC of RDW was 0.730 in the patients with PSA〉20 ng/ml, the highest in the PSA groups.The RDW was positively correlated with increasing risk evaluated by PSA, Gleason score or clinical stage （P〈0.05） .Conclusions RDW of PCa patients is higher than BPH, and it is the independent factor correlating with prostate biopsy results, which can be used to predict positive prostate biopsy, especially in patients with PSA〉20 ng/ml.Therefore, RDW can be used to evaluate the risk of prostate cancer.