血清CXCL4L1、PSA联合超声参数在前列腺癌术后Gleason分级预测中的价值研究

Study on the value of serum CXCL4L1,PSA combined with ultrasonic parameters in predicting Gleason grade after prostate cancer surgery

目的:探讨血清CXC趋化因子配体4L1(CXCL4L1)、前列腺特异抗原(PSA)联合超声参数对前列腺癌术后格里森(Gleason)分级的预测价值。方法:选取2021年6月至2022年12月江西省新余市人民医院行经尿道前列腺电切术治疗的100例前列腺癌患者为研究对象,根据术后Gleason分级分为低中危组(Gleason评分≤7分,70例)、高危组(Gleason评分≥8分,30例);比较两组血清CXCL4L1、总前列腺特异抗原(tPSA)、游离前列腺特异抗原(fPSA)水平及超声参数〔前列腺特异抗原密度(PSAD)、前列腺内腺特异抗原密度(IGPSAD)、前列腺外腺特异抗原密度(EGPSAD)、超声评分〕;评价血清CXCL4L1、fPSA、tPSA、超声参数对术后Gleason分级的预测价值。结果:高危组血清CXCL4L1、fPSA、tPSA水平高于低中危组,PSAD、IGPSAD、EGPSAD、超声评分高于低中危组(P<0.05);血清CXCL4L1、fPSA、tPSA、超声参数联合预测术后Gleason分级的AUC大于各指标单独预测(P<0.05)。结论:血清CXCL4L1、PSA、超声参数与前列腺癌术后Gleason分级、临床病理特征密切相关,联合检测其水平对术后Gleason分级具有一定预测价值。

Objective:To investigate the predictive value of serum CXC chemokine ligand 4L1(CXCL4L1)and prostate specific antigen(PSA)combined with ultrasonic parameters for Gleason grade after prostate cancer surgery.Methods:A total of 100 patients with prostate cancer who underwent transurethral resection of prostate in Xinyu People’s Hospital of Jiangxi Province from June 2021 to December 2022 were selected as the research subjects and divided into low-medium risk group(Gleason score≤7,70 cases)and high-risk group(Gleason score≥8,30 cases)according to postoperative Gleason grade.The levels of serum CXCL4L1,total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),and ultrasound parameters[prostate specific antigen density(PSAD),prostate internal gland specific antigen density(IGPSAD),prostate external gland specific antigen density(EGPSAD),ultrasound score]were compared between the two groups.The predictive value of serum CXCL4L1,fPSA,tPSA,and ultrasound parameters for postoperative Gleason grade was evaluated.Results:The serum levels of CXCL4L1,fPSA,and tPSA in the high-risk group were higher than those in the low-medium risk group,while PSAD,IGPSAD,EGPSAD,and ultrasound scores were higher than those in the low-medium risk group(P<0.05);the AUC predicted by the combination of serum CXCL4L1,fPSA,tPSA,and ultrasound parameters for postoperative Gleason grade was greater than that predicted by each indicator alone(P<0.05).Conclusion:Serum CXCL4L1,PSA and ultrasound parameters are closely related to the Gleason grade and clinicopathological features after prostate cancer surgery.The combined detection of CXCl4L1 and PSA levels has certain value in predicting the Gleason grade after prostate cancer surgery.