PSA、fPSA、CEA在前列腺癌中表达的影响因素与预后不良的探讨

Expression of PSA,fPSA and CEA in Prostate Cancer and Analysis of Their Influencing Factors

目的探讨血清前列腺特异性抗原(PSA)、游离前列腺特异性抗原(fPSA)、癌胚抗原(CEA)在前列腺癌患者中表达的影响因素及其与预后不良的关系。方法采用回顾性方法,选取2018年1月到2020年12月期间本院收治的120例前列腺癌患者作为前列腺癌组,100例前列腺良性增生患者作为良性增生组。同期选择体检中心健康体检者100例作为健康对照组,检测3组研究对象的血清PSA、fPSA、CEA水平,比较其在不同临床病理特征患者中的差异,采用多因素logistic回归分析其与预后不良的关系。结果前列腺癌组患者血清PSA、fPSA、CEA水平明显高于良性增生组,良性增生组患者的PSA、fPSA、CEA水平明显高于健康对照组,差异有统计学意义(P<0.05)。血清PSA、fPSA、CEA水平在年龄≥60岁、Gleason评分≥7分、TNM分期Ⅲ+Ⅳ期、高分化、有淋巴结转移、有骨转移的患者中阳性表达率高于年龄<60岁、Gleason评分<7分、TNM分期Ⅰ+Ⅱ期、低分化、无淋巴结转移、无骨转移的患者(P<0.05)。PSA≥10.05μg/mL、fPSA≥1.50μg/mL、CEA≥20 ng/mL是前列腺癌发生预后不良的独立危险因素(P<0.05)。结论血清PSA、fPSA、CEA在前列腺癌患者中明显升高,是发生预后不良的独立危险因素,可以作为临床病理特征评估及预测预后的重要指标。

Objective To investigate the expression and influencing factors of serum prostate specific antigen(PSA),free prostate specific antigen(fPSA)and carcinoembryonic antigen(CEA)in patients with prostate cancer.Methods Retrospective methods were used to select 120 patients with prostate cancer admitted to our hospital from January 2018 to December 2020 as prostate cancer group and 100 patients with benign hyperplasia of prostate as benign hyperplasia group.During the same period,100 healthy subjects in physical examination center were selected as the healthy control group.Serum PSA,fPSA and CEA levels of the three groups of subjects were detected,and their differences in patients with different clinicopathological characteristics were compared.Multivariate logistic regression was used to analyze their independent risk factors.Results The serum levels of PSA,fPSA and CEA in prostate cancer group were significantly higher than those in benign hyperplasia group,and the levels of PSA,fPSA and CEA in benign hyperplasia group were significantly higher than those in healthy control group,the difference was statistically significant(P<0.05).Serum PSA,fPSA and CEA levels were significantly higher in patients aged≥60 years old,Gleason score≥7,TNM stageⅢ+Ⅳ,high differentiated,with lymph node metastasis and bone metastasis than in patients aged<60 years old,Gleason score<7,TNM stageⅠ+Ⅱ,low differentiated,without lymph node metastasis or bone metastasis,the difference was statistically significant(P<0.05).PSA≥10.05μg/mL,fPSA≥1.50μg/mL,CEA≥20 ng/mL were independent risk factors for poor prognosis of prostate cancer(P<0.05).Conclusion Serum PSA,fPSA and CEA are significantly elevated in patients with prostate cancer,which are independent risk factors for poor prognosis and can be used as important indicators for clinicopathological evaluation and prognosis prediction.