血清睾酮和前列腺特异抗原水平对早期前列腺癌的诊断价值

Diagnostic value of serum testosterone and prostate specific antigen levels for early prostate cancer

目的探讨血清睾酮和前列腺特异抗原(PSA)联合检测对早期前列腺癌的诊断价值。方法选取2018年1月至2019年2月间四川省广元市第一人民医院收治的97例早期前列腺癌患者作为研究1组,抽取同期就诊的81例前列腺增生患者作为研究2组,同期进行健康体检的79例正常受试者作为对照组,观察三组睾酮和PSA水平及二者对早期前列腺癌的诊断价值。结果三组组间睾酮和PSA水平比较,差异有统计学意义(P <0. 05),进一步两两比较显示,研究2组和对照组的睾酮水平高于研究1组,PSA水平高于研究1组,差异均有统计学意义(均P <0. 05)。研究2组和对照组的睾酮水平比较,差异无统计学意义(P> 0. 05),研究2组PSA水平高于对照组,差异有统计学意义(P <0. 05)。睾酮诊断前列腺癌105例,漏诊24例,误诊32例;PSA诊断前列腺癌80例,漏诊35例,误诊18例;睾酮或PSA之一阳性诊断前列腺癌133例,漏诊5例,误诊41例;睾酮和PSA二者均阳性诊断前列腺癌62例,漏诊42例,误诊7例。睾酮或PSA之一阳性诊断前列腺癌的灵敏度高于睾酮、PSA及睾酮和PSA均阳性,差异均有统计学意义(均P <0. 05);睾酮和PSA均阳性诊断前列腺癌的特异性高于睾酮、PSA和睾酮或PSA之一阳性,差异均有统计学意义(均P <0. 05)。结论 PSA和睾酮联合诊断方式有助于诊断前列腺癌,值得临床推广应用。

Objective To investigate the diagnostic value of serum testosterone and prostate specific antigen(PSA)for the early stage of prostate cancer.Methods Ninety-seven patients with early stage prostate cancer who underwent pathological diagnosis at First People’s Hospital of Guanyuan from January2018 to February 2019 were enrolled in study group 1.Eighty-one patients with benign prostatic hyperplasia who were treated at our hospital at the same time were selected as study group 2.Another 79 healthy subjects who had physical examination at this at our hospital at the same time were included in the control group.The testosterone,PSA levels and their diagnostic value for early prostate cancer were observed in the three groups.Results There were significant differences in testosterone and PSA levels among the three groups(all P<0.05).Further comparison showed that the testosterone and PSA levels were higher in study group 2 and the control group than in study group 1(all P<0.05).There was no significant difference in the testosterone levels between the study group 2 and the control group(P>0.05).The PSA level was higher in the study group 2 than in the control group(P<0.05).A total of 105 patients were diagnosed with prostate cancer by testosterone with 24 missed diagnosis and 32 misdiagnosis.A total of 80 patients were diagnosed with prostate cancer by PSA with 35 missed diagnosis and 18 misdiagnosis.A total of 62 patients were diagnosed with prostate cancer by positive testosterone or PSA with 5 missed diagnosis and 41 misdiagnosis.A total of 62 patients were diagnosed with prostate cancer by positive testosterone and PSA with 42 missed diagnosis and 7 misdiagnosis.The sensitivity of positive testosterone and PSA for prostate cancer was higher than that of single testosterone,single PSA,positive testosterone or positive PSA(all P<0.05).Conclusion The combination diagnosis method of PSA and testosterone are helpful for the diagnosis of prostate cancer,which is worthy of clinical application.