前列腺特异性抗原异常的前列腺增生患者穿刺及术后病理特征分析

Analysis of the pathological characteristics after biopsy and surgery in BPH patients with abnormal serum PSA level

目的探讨良性前列腺增生(BPH)患者血清PSA异常升高与组织病理特征可能的关系。方法收集我院自2007年1月至2014年1月464例前列腺增生并PSA异常的患者行手术治疗的临床资料,包括年龄、血清PSA、前列腺体积、移行区指数与穿刺及术后病理,使用SPSS 18.0软件进行卡方检验、方差分析与秩和检验。结果术前血清PSA>20ng/mL、15~20ng/mL、10~<15ng/mL、4~<10ng/mL 4组患者的年龄(P=0.018)、前列腺体积(P<0.001)、移行区体积(P<0.001)、移行区指数(P=0.005)、术后病理(P=0.047)及总的病理分布(P=0.009)存在统计学差异。随着PSA的逐渐升高,前列腺增生患者病理中单纯增生所占的比例逐渐降低,炎症及上皮内瘤变所占的比例逐渐增高。结论 BPH患者血清PSA异常与病理分布相关,炎症及上皮内瘤变可能会引起患者血清PSA升高。

Objective To evaluate the possible relationship between serum prostate specific antigen （PSA） and pathologi- cal characteristics in men who received surgery for benign prostatic hyperplasia （BPH）. Methods The clinical data of 464 consecutive BPH patients who received biopsy and surgery during Jan. 2007 and Jan. 2014 in a single center were retrospectively analyzed,including pretreatment baseline serum PSA, age, prostate volume, transition zone of prostate volume, prostate transi- tion zone index, and pathological results after biopsy or surgery. SPSS 18.0 software was applied to perform chi-square test, vari- ance analysis and Kruskal-Wallis test. Results There were significant differences in age （P = 0. 018）, prostate volume （P〈 0. 001）, transition zone of prostate volume （P〈0. 001）, and prostate transition zone index （P = 0. 005）, pathological results （P = 0.047）, and total pathological distribution （ P = 0.009） among patients with serum PSA level 〉20,15 - 20,10 -〈 15, and 4 %10 ng/mL. Patients with higher PSA level had more inflammation or intraepithelial neoplasia in the pathological analysis. Oonclusion PSA level remains an important prognostic marker for predicting abnormal pathological results for BPH patients, and inflammation or intraepithelial neoplasia may result in higher PSA level.