前列腺健康指数对前列腺特异性抗原处于灰区前列腺癌的诊断价值

Diagnostic value of prostate health index in the diagnosis of prostate cancer in patients with PSA in gray area.

目的观察前列腺健康指数(PHI)对血清前列腺特异性抗原(PSA)处于灰区(4~10μg/L)前列腺癌的诊断价值。方法回顾性选取2018年1月至2019年12月上海健康医学院附属嘉定区中心医院收治的血清PSA处于灰区前列腺癌患者20例,将其作为前列腺癌组,并将同期收治的前列腺良性病变患者22例作为良性组。对两组患者的血清总PSA(PSA)、游离PSA(fPSA)以及PSA前体(p2PSA)进行检测,计算PHI以及各PSA百分比,绘制两组患者的受试者操作特征曲线(ROC),对曲线下面积(AUC)进行计算,比较不同Gleason评分患者各检测参数,评估PHI诊断前列腺癌侵袭性的价值。结果前列腺癌组患者的p2PSA、p2PSA百分比以及PHI分别为(21.18±3.42)ng/L、(1.62±0.21)%、(41.48±5.73),与良性组的(13.59±3.32)ng/L、(1.01±0.11)%、(27.13±4.28)比较,差异均具有统计学意义(P<0.05);与fPSA百分比、PSA相比,PHI、p2PSA百分比AUC值分别为0.768、0.774,明显较高,差异均具有统计学意义(P<0.05);前列腺组患者的Gleason评分≥7分组患者PHI(53.28±3.67)明显高于≤6分组患者(30.23±2.42),差异具有统计学意义(P<0.05)。结论PHI与前列腺癌侵袭呈现出明显正相关,能够有效检出PSA处于灰区的前列腺癌,具有较高临床诊断价值。

Objective To observe the value of prostate health index(PHI)in the diagnosis of prostate cancer with serum prostate specific antigen(PSA)in the gray area(4~10μg/L).Methods Retrospective analysis was performed,20 prostate cancer patients with PSA in gray area from January 2018 to December 2019 were selected from the Central Hospital of Jiading District affiliated to Shanghai Health Medical College as prostate cancer group,and 22 patients with prostate benign lesions were selected as benign group.The serum total PSA(PSA),free PSA(FPSA)and PSA precursor(p2psa)of the two groups were measured,the phi and the percentage of PSA were calculated,the operating characteristic curve(ROC)of the two groups were drawn,the area under the curve(AUC)was calculated,the detection parameters of patients with different Gleason scores were compared,and the value of pHi in the diagnosis of prostate cancer invasiveness was evaluated.Results The percentage of p2psa/p2psa and phi in prostate cancer group were(21.18±3.42)ng/L,(1.62±0.21)%and(41.48±5.73),respectively.Compared with those in benign group(13.59±3.32)ng/L,(1.01±0.11)%and(27.13±4.28),the differences were statistically significant(P<0.05).Compared with the percentage of FPSA and PSA,the percentage of phi and p2psa were statistically significant(P<0.05).AUC was 0.768 and 0.774,respectively,which were significantly higher(P<0.05);phi of patients with Gleason score≥7 in prostate group was significantly higher than that of patients with Gleason score≤6(53.28±3.67)vs.(30.23±2.42),which was statistically significant(P<0.05).Conclusion PHI has a positive correlation with prostate cancer invasion,which can effectively detect prostate cancer with PSA in gray area,and has a high clinical diagnostic value.