PSA灰区患者术前检查与其前列腺穿刺阳性情况的相关性分析

Relationship of prostate biopsy positive results and preoperative examination in prostate specific antigen gray area patients

目的 研究前列腺特异性抗原（PSA）灰区患者术前检查与其前列腺穿刺阳性情况的相关性。方法 回顾性研究2011年3月~2016年3月在沭阳县中心医院泌尿外科和徐州市中心医院泌尿外科就诊的处于PSA灰区进行前列腺穿刺活检检查的495例患者,根据穿刺结果将其分为穿刺阳性组（n=150）和穿刺阴性组（n=345）,比较两组年龄、是否吸烟、是否高血压、是否有糖尿病、MRI结节、直肠指检（DRE）结节、PSA、游离PSA（FPSA）、PSA密度（PSAD）、前列腺体积等情况,并对其穿刺阳性结果与术前检查的相关性进行分析。结果 两组患者在年龄、是否吸烟、是否高血压、是否有糖尿病及FPSA、前列腺体积上比较,差异无统计学意义（P=0.1078、0.6375、0.0517、0.4811、0.1363、0.2915,均P〉0.05）,而在MRI结节、DRE结节、PSA、PSAD上比较,差异均有统计学意义（均P〈0.01）。Pearson相关分析结果显示,MRI结节、DRE结节、PSA、PSAD与经直肠前列腺穿刺阳性均存在明显的正相关（r=0.236、0.536、0.331、0.402,均P〈0.05）。结论 处于PSA灰区的患者,若出现PSA较高、PASD较高,MRI或DRE发现结节,则穿刺阳性率较高;年龄、吸烟、高血压、糖尿病、FPSA等与穿刺结果无关。

Objective To investigate correlation of prostate biopsy positive results and preoperative examination in prostate specific antigen （PSA） Gray area patients.Methods 495 patients who underwent prostatic biopsy in the PSA gray area from March 2011 to March 2016 in Department of Urology of Central Hospital of Shuyang County and Xuzhou City Central Hospital were retrospectively studied and divided into two groups of prostatic biopsy positive group （n=150） and prostatic biopsy negative group （n=345） according to the results of prostatic biopsy.Age,smoking or not,whether hypertension,whether diabetes,MR! nodules,digital rectal examination （DRE） nodules,PSA,free PSA （FPSA）,PSA density （PSAD）,prostate volume between two groups were compared,and correlation of puncture positive result and preoperative examination was analyzed.Results There were no significant differences between two groups in age,smoking or not, whether hypertension,whether diabetes,and FPSA,prostate volume between two groups （P=0.1078,0.6375,0.0517,0.4811, 0.1363,0.2915;all P〉0.05）;There were statistically significant difference in MRI nodules,DRE nodules,PSA,PSAD （all P〈0.01）.Pearson correlation analysis results showed that MRI nodules,DRE nodules,PSA,PSAD had positive correlation with transrectal prostate biopsy positive （r=0.236,0.536,0.331,0.536;all P〈0.05）.Conclusion Positive rate of puncture is higher in patients of PSA gray area with higher PSA,higher PASD,MRI or DRE found nodules;age,smoking,hyperten- sion,diabetes,FPSA have no relationship with puncture result.