前列腺特异性抗原检测结果的影响因素分析

A study on factors influencing the prostate-specific antigen

目的 探讨影响PSA测定结果的相关因素。 方法 采用对比分析方法对慢性前列腺炎 (CP) 4 1例 ,良性前列腺增生 (BPH) 16 5例 ,前列腺癌 (PCa) 4 3例 ,非前列腺疾病 2 2例患者直肠指检 (DRE)前后血清PSA值的变化及持续时间进行观察 ;并与膀胱镜检查、留置导尿以及服用非那雄胺对PSA的影响变化进行对比观察。 结果 BPH、CP、PCa、对照组DRE前PSA值分别为 (2 .2 8±2 .0 7)、(3.0 3± 2 .81)、(16 .17± 15 .2 5 )、(0 .93± 0 .96 )ng/ml,F/T值分别为0 .31、0 .39、0 .18、0 .4 1;检查后PSA值为 (4.5 2± 4 .89)、(4.5 4± 3.15 )、(2 1.2 6± 16 .6 8)、(1.17± 1.12 )ng/ml,F/T值为0 .2 9、0 .36、0 .15、0 .37。DRE检查前后PSA变化差异有显著性意义 (P <0 .0 1) ,并以T PSA升高为主。检查后 14天 ,除PCa组外 ,其它PSA值恢复到接近检查前水平。膀胱镜检查、留置导尿第 7天 ,PSA值分别升高 12 0 .4 %及 5 9.1% ,而服用非那雄胺可使血清PSA下降 35 .0 %。 结论 PSA极易受到DRE、尿道操作、服用非那雄胺等因素的影响 ,此影响至少持续 14～ 2 1天。

Objective To study the factors that might influence the PSA-value. Methods Serum samples were collected from 165 cases of benign prostate hyperplasia (BPH),43 cases of prostate cancer (PCa) and 41 cases of chronic prostatitis (CP),both before and after digital rectal examination (DRE),cystoscope examination,indwelling catheterization and finasteride intake. Results In the BPH group,T-PSA elevated from (2.28±2.07)ng/ml to (4.77±5.23)ng/ml, P <0.01;on the 14th day dropped to ( 2.83 ±2.17)ng/ml.In the CP group from (3.03±2.81)ng/ml to (4.54±3.15)ng/ml, P <0.01,and on the 14th day dropped to (3.27±3.21)ng/ml;In the PCa group from (16.17±15.25)ng/ml to (21.26± 16.68 )ng/ml, P <0.01 ,and on the 14th day dropped to (18.15±16.21)ng/ml;In 22 cases of non-prostatic diseases from (0.93±0.96)ng/ml to (1.17±1.12)ng/ml, P <0.5,and on the 14th day dropped to (0.98±0.76)ng/ml.T-PSA elevated were significantly than F-PSA in each group.In all the groups except PCa,the elevated PSA after DRE would drop to the prexamination level in about 2 weeks.On the 7th ady after cystoscopic examination and indwelling catheterization PSA elevated 120.4% and 59.1% respectively whereas after finasteride intake PSA dropped 35.0%. Conclusions Serum PSA-value is usually influenced by DRE,catheterization and the others,and the influence would last 2～3 weeks or even longer.