血清高敏C反应蛋白在前列腺穿刺活检诊断前列腺癌中的意义

Significance of serum high sensitivity C-reactive protein in prostate biopsy diagnosis of prostate cancer

目的探讨血清高敏C反应蛋白(hs-CRP)在前列腺穿刺活检诊断前列腺癌中的意义。方法选取行经直肠超声引导下前列腺穿刺活检患者347例,经病理确诊前列腺癌122例和良性前列腺增生225例。比较前列腺癌和良性前列腺增生患者年龄、血清hs-CRP、总前列腺癌的特异性标志物(tPSA)、前列腺总体积(TPV)及PSA密度(PSAD)等指标,比较血清hs-CRP升高者与正常者有关指标及穿刺阳性率,对影响前列腺穿刺阳性率相关指标进行Logistic回归分析。结果前列腺癌患者血清hsCRP浓度(3.57±1.25)mg/L,显著高于良性前列腺增生患者的(1.36±0.97)mg/L,差异具有统计学意义(P<0.05);血清hsCRP浓度>3 mg/L组患者tPSA和PSAD均高于≤3 mg/L组;穿刺阳性率为57.3%,显著高于≤3 mg/L组的26.5%(P<0.05),且差异具有统计学意义(P<0.05);Logistic回归分析显示,年龄、hs-CRP、tPSA和TPV是前列腺穿刺阳性率的独立影响因素(P<0.05),hs-CRP的OR值=1.132(95%CI:1.027~1.307),高于其他3个因素。结论对怀疑前列腺癌行经直肠前列腺穿刺活检的患者应进行血清hs-CRP检测,血清hs-CRP浓度升高时穿刺活检前列腺癌检出率提高。

Objective To investigate the significance of serum high sensitivity C-reactive protein in prostate biopsy diagnosis of prostate cancer.Methods 347 cases of patients undergoing transrectal ultrasound guided prostate biopsy were selected.The pathological findings showed 122 cases with prostate cancer and 225 cases with benign prostatic hyperplasia.The age,serum hs-CRP,total prostate cancer-specific markers（tPSA）,total prostate volume（TPV）and PSA density（PSAD）and other indicators between prostate cancer and benign prostatic hyperplasia were compared.The indicators and positive biopsy rates between serum hs-CRP elevated and normal were compared.The prostate biopsy positive rate related indicators were analyzed by Logistic regression analysis.Results The serum hs-CRP concentration in patients with prostate cancer was（3.57±1.25）mg/L,which was significantly higher than in patients with benign prostatic hyperplasia（1.36±0.97）mg/L,the difference was statistically significant（P0.05）.The tPSA and PSAD in serum hs-CRP concentrations3mg/L group were higher than≤3mg/L group（P0.05）,biopsy positive rate was 57.3%,which was significantly higher than 26.5% of≤3mg/L group（P0.05）.Logistic regression analysis showed that,age,hs-CRP,tPSA and TPV were independent factors for prostate biopsy positive rate（P0.05）.The OR value of hs-CRP was 1.132（95%CI：1.027-1.307）,which was higher than the other three factors.Conclusion It should be conducted to detect serum hs-CRP for patients suspected prostate cancer undergoing transrectal prostate biopsy.The serum hs-CRP level elevated was associated with the prostate biopsy positive rate increased.