血清PSA检测应用前后前列腺癌患者临床特点分析

目的评价北京友谊医院开展PSA检测前后前列腺癌患者的临床诊疗特点。方法回顾295例前列腺癌患者的临床资料，分析患者年龄、前列腺总体积、临床症状、临床分期、肿瘤Gleason分级以及治疗方法。PSA检测方法应用之前组117例（A组），PSA检测应用之后组178例（B组），采用t检验及X^2检验分析变量之间的相关性。结果与A组相比较，B组确诊为前列腺癌的患者平均年龄增加（P〈0.01），前列腺总体积增大（P〈0.01），肿瘤分期中位于晚期的肿瘤（T3＋T4期）的患者比例增加（P〈0.01）。Gleason分级5-7分的中分化肿瘤比例增加，接受前列腺癌根治手术比例增加（P〈0.01），而接受去势手术比例减少（P〈0.01）。以下尿路症状为主诉的患者比例两组均较高。站论PSA检测应用后确诊前列腺癌患者的年龄趋于老年化，肿瘤恶性度增高，前列腺总体积增大，但肿瘤分化趋向于较高Gleason评分。早期应用PSA检测能够提高临床前列腺癌的早期诊断率。

Clinical characteristics of prostate cancer patients before and after the application of serum prostate-specific antigen testing

Objective To assess the clinical characteristics of diagnosis and treatment of the prostate cancer patients since prostate-specific antigen （PSA） testing had been used in Beijing Friendship Hospital. Methods The medical records of 295 patients treated in Beijing Friendship Hospital were retrospectively reviewed with respect to age, prostate volume, clinical symptom, clinical stage, Gleason score for the tumor and treatment. We divided the patients into two groups： 117 cases treated before the PSA testing used （group A）, 178 cases treated after the PSA testing used （group B）. We used t-test and X^2 test to analyse all the data. Results Compared with group A, there was significant increase in the patients＇ age, prostate volume and ratio of advanced stage prostate cancer （stage T3, T4 ） and proportion of moderately differentiated tumor with Gleason score 5-7（P〈0.01） after PSA testing was introduced （group B）. There was significant increase in the proportion of patients who underwent radical prostatectomy （P〈0.01） after PSA testing was introduced （group B）. In addition, there was a significant decrease in the proportion of subjects who underwent surgical castration （P〈0.01）. The ratio of patients with chief complaint of low urinary tract symptom was high in both groups. Conclusion Our results demonstrate that after PSA testing was used, age, prostate volume, and the ratio of advanced prostate cancer are significantly higher. But when the tumors get higher Gleason score, the treatment of prostate cancer is more reasonable and integrated. It is beneficial to confirm early diagnosis of prostate cancer with PSA testing and emphasize the clinical symptom.