翁沥通胶囊在前列腺特异性抗原处于灰区前列腺穿刺活检中的应用价值研究

The Application Value of Wenglitong Capsule in Prostate Biopsy with Prostate Specific Antigen in Gray Area

目的探讨翁沥通胶囊在前列腺特异性抗原处于灰区(4~10ng/mL)范围的患者前列腺穿刺活检临床决策中的应用价值。方法回顾性分析前列腺特异性抗原处于灰区、直肠指诊无异常的患者91例,按其是否使用翁沥通胶囊进行治疗分为两组:翁沥通治疗组(使用翁沥通治疗并未立即行前列腺穿刺活检,简称治疗组,n=44)和翁沥通未治疗组(未使用翁沥通治疗并立即行穿刺活检,简称未治疗组,n=47),对两组前列腺穿刺活检的例数、穿刺阳性率、穿刺阴性率、穿刺相关并发症等指标以及治疗组中未行前列腺穿刺活检患者的PSA相关指标的变化进行对比分析。结果治疗组前列腺穿刺阳性率及前列腺上皮内瘤的检出率显著高于未治疗组(P<0.01),同时穿刺阴性率及炎症和良性增生的检出率显著低于未治疗组(P<0.01)。治疗组穿刺患者的并发症发生率明显低于对照组(P<0.01)。治疗组中未行前列腺穿刺活检的19例患者,随着服用翁沥通胶囊治疗的时间延长,其tPSA、PSAD在翁沥通治疗后有明显下降(P<0.05),f/tPSA在翁沥通治疗后开始增高(P<0.05)。结论翁沥通对于PSA处于灰区范围内的患者,有助于区分因非肿瘤因素造成的PSA升高,有利于做出前列腺穿刺活检的临床决策,增加穿刺阳性率。

Objective To investigate the application value of Wenglitong capsule in the clinical decision-making of prostate biopsy in patients with prostate specific antigen(PSA)in the gray area(4-10 ng/mL).Methods 91 patients with PSA in gray area and without abnormality in digital rectal examination were retrospectively analyzed.According to whether they were treated with Wenglitong capsule or not,these patients were divided into two groups:the Wenglitong treatment group(treated with Wenglitong without immediate prostate biopsy,referred to as the treatment group,n=44)and the Wenglitong non-treatment group(without Wenglitong treatment and immediate puncture biopsy,referred to as the untreated group,n=7).The number of prostate biopsy cases,positive rate of prostate biopsy,negative rate of prostate biopsy,biopsy related complications and other indicators of these two groups,as well as PSA related indicators of patients without prostate biopsy in the treatment group were compared and analyzed.Results The positive rate of prostate biopsy and the detection rate of prostatic intraepithelial neoplasia(PIN)in the treatment group were significantly higher than those in the untreated group(P<0.01),while the negative rate of biopsy and the detection rate of inflammation and benign hyperplasia in the treatment group were significantly lower than those in the untreated group(P<0.01).The incidence of complications in the treatment group was significantly lower than that in the control group(P<0.01).In the treatment group,19 patients without prostate biopsy were treated with Wenglitong capsule,and their tPSA and PSAD decreased significantly(P<0.05),also f/tPSA began to increase after Wenglitong treatment(P<0.05).Conclusion Wenglitong can be helpful to distinguish PSA elevation caused by non-tumor factors for patients with PSA in gray area,which is informative to make clinical decision of prostate biopsy and increase the positive rate of prostate biopsy.