前列腺癌患者血清铁蛋白、游离前列腺特异性抗原、尿酸水平与Gleason分级的相关性分析

Correlation of serum ferritin, fPSA, uric acid and Gleason grade in patients with prostate cancer

目的 分析前列腺癌(PCA)患者血清铁蛋白(Ferr)、游离前列腺特异性抗原(fPSA)、尿酸(UA)水平与Gleason分级的相关性。方法 选取2020年3月至2022年3月唐山中心医院诊治的121例行前列腺穿刺的患者作为研究对象。根据穿刺结果将70例PCA患者纳入PCA组,将51例良性前列腺增生(BPH)患者纳入BPH组。测定患者血清中Ferr、fPSA、UA水平,采用Spearman分析Ferr、fPSA、UA水平与Gleason分级的相关性,采用受试者工作特征(ROC)曲线分析Ferr、fPSA、UA指标对PCA的诊断效能。结果 (1)PCA组血清Ferr、fPSA、UA水平均明显高于BPH组(P<0.05)。(2)Ferr、fPSA、UA联合诊断PCA的曲线下面积(AUC)为0.981,灵敏度为94.40%,特异度为96.12%,诊断能力高于Ferr、fPSA、UA单项检测(P<0.05)。(3)PCA患者不同Gleason分级中血清Ferr、UA表达水平比较,差异具有统计学意义(P<0.05)。(4)PCA患者血清fPSA表达水平与Gleason分级无相关性(r=0.119,P=0.492);PCA患者血清Ferr、UA水平与Gleason分级呈正相关(r=0.371,P=0.014;r=0.571,P=0.003)。结论 PCA患者血清fPSA表达水平与Gleason分级无相关性,血清Ferr、UA水平与Gleason分级呈正相关性;Ferr、fPSA、UA联合检测用于诊断鉴别PCA具有一定诊断价值;Ferr、UA可作为预测PCA病理分级的重要指标,可为临床制定治疗方案提供有利指导。

Objective To study the correlation between serum ferritin(Ferr), free prostate specific antigen(fPSA), uric acid(UA) levels and Gleason grade in patients with prostate cancer(PCA). Methods 121 patients who underwent prostate puncture in Tangshan Central Hospital from March 2020 to March 2022 were selected as the study objects. According to the results of puncture, 70 patients with PCA were included in PCA group and 51 patients with benign prostatic hyperplasia(BPH) were included in BPH group. Serum Ferr, fPSA and UA levels were determined. Spearman was used to analyze the correlation between Ferr, fPSA and UA levels and Gleason grading, and receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of Ferr, fPSA and UA indexes in PCA. Results(1) Serum Ferr, fPSA and UA levels in PCA group were significantly higher than those in BPH group(P<0.05).(2) The AUC of combined diagnosis of Ferr, fPSA and UA for PCA was 0.981, the sensitivity was 94.40%, the specificity was 96.12%, and the diagnostic ability was higher than that of Ferr, fPSA and UA, respectively(P<0.05).(3) The expression levels of Ferr and UA in different Gleason grades of PCA patients were significantly different(P<0.05).(4) There was no correlation between the level of serum fPSA expression and Gleason grading in PCA patients(r=0.119, P=0.492);serum Ferr and UA levels in PCA patients were positively correlated with Gleason grading(r=0.371, P=0.014;r=0.571, P=0.003). Conclusions There was no correlation between serum fPSA level and Gleason grade in PCA patients, but serum Ferr and UA level were positive correlated with Gleason grade. The combined detection of Ferr, fPSA and UA is valuable in the diagnosis and differentiation of PCA;Ferr and UA can be used as important indicators to predict the pathological grade of PCA, and can provide beneficial guidance for the formulation of treatment plan.