株洲市年龄≥50岁男性的血清前列腺特异性抗原筛查的调查分析

Investigation and analysis of PSA screening among men over 50 years old in Zhuzhou city

目的探讨株洲市年龄≥50岁男性运用血清前列腺特异性抗原(PSA)筛查前列腺癌(PCa)的临床价值。方法选择2019年1月至2020年1月期间株洲市天元区泰山路社区的1567例年龄≥50岁男性为研究对象,均采集其空腹静脉血,检查PSA水平,然后对于PSA≥4.0 ng/mL者判断为PCa可疑病例,并且及时行前列腺穿刺活检,再选择同期医院收治的35例PCa患者为对照组,对筛查得到的PCa患者与对照组的临床病理分期(TNM)进行比较分析。结果本组的1567例受检者中,109例(6.96%)血清PSA≥4.0 ng/mL,其中7例确诊为PCa,检出率为6.42%;PCa的发病率随着年龄的增加和PSA水平的升高而升高(P<0.05);通过分析PSA的不同浓度水平,发现PCa的发病率随着PSA水平的上升而升高,且差异具有统计学意义(P<0.05)。两组患者PCa病理分级情况比较,差异无统计学意义(P=0.112)。与对照组比较,观察组T2期以下的局限癌所占比例较高,而T3期以上的进展期癌所占比例较低,组间比较差异均有统计学意义(均P<0.05)。结论对于社区老年男性人群,运用血清PSA对PCa进行筛查可以尽早发现PCa,是比较有效的一种方法,有助于尽早治疗,改善患者预后。

Objective To explore the clinical value of serum prostate specific antigen(PSA)screening for prostate cancer(PCa)in men over 50 years old in Zhuzhou city.Methods From January 2019 to January 2020,1567 men over 50 years old in Taishan road community,Tianyuan district,Zhuzhou city were selected as the research objects.Fasting venous blood was collected to check the PSA level.Then those with PSA≥4.0 ng/mL were judged as suspicious cases of PCa,and prostate biopsy was performed in time.Furthermore,35 patients with PCa treated in the hospital in the same period were selected as the control group,the TNM stages of PCa patients diagnosed by PSA screening and the control group were compared and analyzed.Results Among the 1567 subjects,109 cases(6.96%)had serum PSA≥4.0 ng/mL,of which 7 cases were diagnosed as prostate cancer,and the detection rate was 6.42%.The incidence of PCa increased with age and PSA levels(P<0.05).The incidence of PCa increased with the increase of PSA levels,and the difference was statistically significant(P<0.05).There was no significant difference in PCa pathological grade between the two groups(P=0.112).Compared with the control group,the proportion of localized cancer below T2 in the observation group was higher,contrarily,the proportion of advanced cancer above T3 was lower.The comparison between the groups was statistically significant(all P<0.05).Conclusions For the elderly male population in the community,serum PSA screening is an effctive method to find PCa as early as possible,which is helpful for patients to get early treatment and better prognosis.