前列腺组织学炎症分级对前列腺良性疾病及前列腺癌患者血清PSA的影响

The effect of prostate histologic inflammation classification on serum PSA in patients with benign prostatic disease and prostate cancer

目的探讨前列腺组织学炎症分级对DRE正常、血清PSA>4 ng/ml的前列腺活检患者PSA水平的影响。方法选取2018年1月至2020年2月本院收治的55例BPD患者和31例前列腺癌患者的组织标本,进行组织病理学分析。活检前,对所有患者进行直肠指诊和血清PSA检测。炎症类型分为腺体、腺体周围、间质和血管周围型,炎症程度为1~3级。结果 BPD患者中,血清总PSA水平与前列腺体积及年龄无相关性。患者穿刺标本组织学分析,BPD患者腺体、腺体周围和间质炎症情况与血清PSA无显著相关性。血管周围炎症则会使PSA水平升高,差异有统计学意义(P<0.05)。BPD患者中,腺体、腺体周围、间质和血管周围炎症情况与前列腺体积间无显著相关性。腺体、腺体周围、间质和血管周围炎症情况与年龄间无显著相关性。PCA患者中,血清PSA水平与体积、年龄间无显著相关性。腺体、腺体周围、间质和血管周围炎症情况与患者血清PSA水平、前列腺体积、年龄间均无显著相关性。结论血管周围炎症使血清PSA水平升高,提示在今后的临床工作中,穿刺标本病理阴性的患者病理报告中,可增加描述出炎症细胞的解剖位置(腺体、腺体周围、间质和血管周围),根据组织学的结果确定随访时间和再活检时间,且PIN患者必须密切随访,必要时再次活检。

Objective To determine the effect of prostate histologic inflammation classification on PSA levels in patients with normal DRE and serum PSA>4 ng/ml were performed prostate biopsy. Methods The tissue specimens of 55 patients with BPD and 31 patients with prostate cancer treated in our hospital from January 2018 to February 2020 were selected for histopathological analysis. Digital rectal examination and serum PSA were performed in all patients before biopsy. The types of inflammation were divided into glandular, periglandular, interstitial and perivascular types,and the degree of inflammation was grade 1-3. Results No relation was found between serum PSA levels and prostate volume or age in BPD group.Histological analysis of puncture specimens showed that there was no significant correlation between serum PSA and glandular, periglandular and stromal inflammations in BPD. Perivascular inflammation increased PSA levels significantly in BPD(P<0.05).There was no significant correlation between glandular, periglandular, stromal, and perivascular inflammation and prostate volume in BPD. There was no significant correlation between age and glandular, periglandular, stromal and perivascular inflammation in BPD. There was no significant correlation between serum PSA levels and volume and age in PCA. There was no significant correlation between serum PSA levels, prostate volume and age of patients with glandular, periglandular, stromal and perivascular inflammations in PCA. Conclusion Inflammation in the perivascular area increases serum PSA levels. It suggests that in future clinical work, the pathological report of pathologically negative patients with puncture specimens can increase the description of the anatomic sites of inflammatory cells(glandular, periglandular, stromal, perivascular). Follow-up and rebiopsy times are determined based on histological findings, and PIN patients must be closely followed up and rebiopsied if necessary.