县域范围内血清PSA检测联合前列腺穿刺活检对前列腺癌的诊断意义

The significance of serum PSA detection combined with prostate biopsy in the diagnosis of prostate cancer in the county

目的:探讨县域范围内血清前列腺特异性抗原(PSA)水平检测联合前列腺穿刺活检对前列腺癌的诊断价值。方法:选取我县2016年1月至2019年12月行血清PSA检测并行前列腺穿刺活检术的患者,统计分析所有患者的血清PSA水平及其分布情况、穿刺活检结果及穿刺活检并发症。结果:共纳入307例患者,血清PSA水平为(18.64±6.11) ng·ml^(-1),PSA水平0~4.0、4.1~10.0、10.1~20.0和> 20.0 ng·ml^(-1)组的患者分别占4.56%、20.52%、22.80%和52.12%。随着PSA水平及年龄的增高,前列腺癌检出率呈增高趋势,不同血清PSA水平组及不同年龄组前列腺癌检出率差异有统计学意义(P <0.05)。结论:不同血清PSA水平或不同年龄的前列腺疾病患者前列腺癌检出率差异显著,血清PSA水平4 ng·ml^(-1)以上者穿刺活检前列腺癌检出率超过20%,故临床可将血清PSA水平>4 ng·ml^(-1)作为可疑前列腺癌穿刺活检指标,实现前列腺穿刺活检诊断效能最优化。

Objective: To explore the value of serum prostate-specific antigen( PSA) level measurements combined with prostate biopsy in the diagnosis of prostate cancer in the county area. Methods: We selected patients in our county who underwent serum PSA testing and prostate biopsy between January 2016 and December2019. Statistical analysis was performed on serum PSA levels,PSA level distributions,and needle biopsy results of all patients. Results: For the 307 patients enrolled,the serum PSA level was( 18. 64 ± 6. 11) ng·ml^(-1),and the percentages of patients with PSA levels in the ranges of 0-4. 0,4. 1-10. 0,10. 1-20. 0 and > 20. 0 ng·ml^(-1) were 4. 56%,20. 52%,22. 80% and 52. 12%,respectively. The detection rate of prostate cancer increased with the increase of PSA level and age,with significant differences between groups of different serum PSA levels and different ages( P < 0. 05). Conclusion: There are significant differences in the detection rates of prostate cancer in patients with different PSA levels or different ages,and the detection rate of needle biopsy in patients with PSA serum levels above 4 ng · ml^(-1) was above 20%,so a PSA serum level of > 4 ng · ml^(-1) could be used as an clinical indicator of needle biopsy for suspicious prostate cancer,and can optimize the diagnostic efficiency of prostate biopsy.