血前列腺特异抗原的相关影响因素及其在前列腺癌筛查中的意义

The Factors Relating to Prostate Specific Antigen and Prostate Cancer Screening

目的：探讨血前列腺特异抗原（PSA）的相关影响因素及其在前列腺癌筛查中的意义。方法：随机选取1572名40岁以上健康体检的男性，进行血PSA检查及相关问卷的调查。结果：血PSA水平与尿不净、中断排尿、排尿费力、尿频、尿急、夜尿都存在正相关关系，但相关性不高；年龄与血PSA水平有明确的相关性；血PSA水平与吸烟、豆制品、西红柿、饮食类型有相关性；是否患有糖尿病、高血压、肿瘤、睾丸疾病与血PSA水平无明显相关性；当血PSA〉4．0．g／ml时，人们接受无创性影像学检查如MRI的比例较高，约95．7％；而接受有创性检查如前列腺穿刺活检的比例较低，约9．7％；在1572名行血PSA检查的人群中前列腺癌检出率约0．19％。结论：对于血PSA检测结果应进行综合分析，且依据血PSA检查结果指导病人何时行前列腺MRI检查及（或）前列腺穿刺活检，以避免过度医疗同时有效减少漏诊率。

OBJECTIVE： To discuss the related influence factors of blood PSA and its signigicance in peostate cancer screening. METHODS： 1572 healthy men individuals （ 〉40 years old） were randomly selected. Among them blood PSA tests and questionnaire survey were made. RESULTS： Blood PSA levels were positively related to interrupt micturition, micturition arduous, urinary frequency, urgency and nocturia, but the correlation was not high. Age was clearly related to blood PSA level. Blood PSA levels were related to smoking, bean products, tomatwes and type of diet. Diabetes, hypertension, cancer and testicular diseases were not obviously related to blood PSA level. At blood PSA 〉 4. 0ng/ml, people who accepted noninvasive imaging examination such as MRI was high （95.7%） and who accepted invasive examination such as prostate biopsy was low （9. 7% ）. Prostate cancer detected was about 0. 19% among 1572 people who tested blood PSA. CONCLUSION： Comprehensive analysis should be done for blood PSA test results. And the patients should be told when MRI of the prostate and prostate biopsy should be done on the basis of blood PSA test results.