BPH并前列腺炎对血清PSA的影响

目的：探讨BPH并前列腺炎对患者血清PSA的影响。方法：收集2006年9～12月期间在四川大学华西医院行经尿道前列腺电切术的BPH患者52例,术前行经直肠前列腺B超柃查,检测血清PSA,记录年龄和是否存在急性尿潴留;术中切取前列腺组织用于细菌16SrDNA Real—time PCR检测和病理检查,诊断有无前列腺炎、炎症程度和炎症类型。采用Logistic多元回归方法,纳入尿潴留、前列腺感染、前列腺体积和年龄等因素的同时分析前列腺腺周炎症、前列腺腺体炎症是否与血清PSA浓度有关。结果：前列腺腺周炎症、前列腺体积和血清PSA升高有关（P=0．027和0．001）。结论：除了前列腺体积外,前列腺腺周炎症是BPH患者血清PSA升高的危险因素。     

前列腺炎对血清PSA水平的影响

PSA是诊断和鉴别诊断前列腺癌的一项重要指标 ,但许多良性前列腺疾病也导致血清PSA升高。本文综述了前列腺炎导致血清PSA升高的机理 ,不同类型前列腺炎对血清PSA升高的影响 ,前列腺液成分的变化与血清PSA升高的关系以及前列腺炎对其它PSA相关指标的影响等方面。     

前列腺炎对血清PSA浓度的影响

目的 :探讨前列腺炎对血清 PSA浓度的影响。方法 :选择 48例 2 1～ 40岁的前列腺炎患者 ,用 EL ISA法测定直肠指检前的血清 PSA浓度 ,与正常组 2 1例对照 ,并对比治疗前后血清 PSA浓度的变化。结果 :前列腺炎组和对照组的血清 PSA浓度分别为 (1.5± 0 .4)和 (0 .4± 0 .2 ) μg/ L,两组间有极显著性差异 (t=11.96 ,P<0 .0 0 1) ;31例治疗有效者 ,治疗后血清 PSA浓度较治疗前明显下降 (P <0 .0 0 1) ,而 12例无效者 ,血清 PSA浓度较治疗前下降不明显 (P >0 .0 5 )。结论 :前列腺炎时血清 PSA浓度明显升高 ,但随着炎症的消失 ,PSA浓度可逐渐恢复正常。     

前列腺炎患者前列腺液成分与血清PSA含量的关系

目的 :探讨前列腺炎患者前列腺按摩液 (EPS)中卵磷脂小体及白细胞 (WBC)含量与血清前列腺特异性抗原(PSA)升高之间的关系 ,以及细菌性与非细菌性前列腺炎对血清PSA浓度的影响。　方法 :ELISA法测定 6 2例慢性前列腺炎患者及 2 2例正常人的血清PSA含量。分析EPS中卵磷脂小体及WBC含量与血清PSA升高的相关性 ,并比较细菌性与非细菌性前列腺炎患者平均血清PSA间的差异。　结果 :前列腺炎患者血清PSA含量为 (1.79± 0 .6 8)μg/L ,明显高于对照组的 (0 .6 3± 0 .2 9) μg/L (P <0 .0 0 1)。EPS镜检白细胞含量低的 (+～ ++)与含量高的 (+++～ ++++)两组患者的血清PSA含量比较差异有显著性 (P <0 .0 5 )。卵磷脂小体含量低的 (-～ ++) 35例与含量高的 (+++～ ++++) 2 7例患者的血清PSA含量比较差异无显著性 (P >0 .0 5 )。细菌性与非细菌性炎性前列腺炎患者血清PSA含量比较差异无显著性 (P >0 .0 5 )。　结论 :前列腺炎可以导致血清PSA升高 ,这种升高与EPS中WBC的含量呈正相关 ,与卵磷脂小体的含量无关 ,与前列腺炎类型 (细菌性或非细菌性 )无关。     

抗炎治疗后NIH-Ⅳ型前列腺炎患者血清PSA的变化

目的：探讨抗炎治疗后美国国立卫生院（NIH）-Ⅳ型前列腺炎患者血清前列腺特异性抗原（PSA）的变化.方法：对经筛选符合入选标准的68例、PSA增高（≥4 μg/L）、拟行前列腺穿刺活检的NIH-Ⅳ型前列腺炎患者,予左氧氟沙星（0.5,口服,1/d）＋复方磺胺甲恶唑片（SMZ）（1.0,口服,2/d）治疗2周,治疗后复查PSA和前列腺液（EPS）.分析PSA的变化及其与治疗效果（EPS中WBC≤10/HP为有效,WBC＞10/HP为无效）的关系.结果：68例患者治疗前PSA值为（9.76±4.26）μg/L,治疗后为（4.32±2.92）μg/L（P＜0.01）,其中治疗有效28例（P＜0.01）.治疗后PSA＜4 μg/L的患者26例,其中治疗有效23（P＜0.01）;治疗后仍PSA≥4 μg/L的患者42例,其中治疗有效5例.结论：抗炎治疗2周后患有NIH-Ⅳ型前列腺炎、PSA≥4 μg/L患者,血清PSA值明显下降,超过1/3患者血清PSA下降至正常而免于前列腺穿刺活检;PSA的下降与抗炎治疗效果相关.     

慢性前列腺炎对血清PSA水平的影响

目的 :研究慢性前列腺炎 (chronicprostatitis ,CP)中前列腺特异性抗原 (PSA)水平。　方法 :选择诊断为ⅢA型前列腺炎患者 4 5例 ,30例健康男性为正常对照 ,分别检测血清PSA水平 ,并进行分析。　结果 :在 4 5例ⅢA型前列腺炎患者中 ,血清PSA水平为 2 .4 1± 0 .6 4 μg/L ,而正常对照组为0 .93± 0 .5 2 μg/L ,2组PSA水平差异具有显著性(P <0 .0 5 )。其中 ,ⅢA型前列腺炎患者中血清PSA超过 4 .0 μg/L的共有 6例 (1 3.3%) ,而正常对照组中仅有 1例(3.3%)。ⅢA型前列腺炎患者中 ,随着前列腺按摩液内白细胞数增加 ,PSA水平有一定程度的增高 ,但没有显著性差异。　结论 :ⅢA型前列腺炎可以使血清PSA水平有一定程度的增高 ,在诊断过程中应予以考虑。     

非前列腺癌血清前列腺特异性抗原分析

采用RIA法对745例非前列腺癌人员血清前列腺特异性抗原（PSA）进行检测，结果56例女性组中有11例检测到PSA，检出率为19％，平均检测值为0．61±0．34ng／ml；309例非前列腺疾病组血清PSA随年龄升高而增加，其中30岁和60岁时有两个升高速度较快的过程，这与前列腺生长情况是平行的；103例慢性前列腺炎组和277例良性前列腺增生组的PSA值变化情况与非前列腺疾病组情况相似，但将此两组PSA与非前列腺疾病组在同年龄段进行比较，以60岁年龄段和70岁年龄段为更显著。另外，笔者还观察了部分手术对血清PSA的影响，发现非前列腺手术血清PSA会下降。认为本研究是一个较大样本的血清PSA检测，年龄范围较广，有一定的临床参考价值。     

抗生素及非甾体类消炎药对ⅢA型前列腺炎血清PSA及游离PSA的影响

目的:探讨炎症性慢性骨盆疼痛综合征(ⅢA)患者经过抗生素及非甾体类消炎药治疗的血清前列腺特异性抗原(PSA)水平及游离PSA百分率(F-PSAR)的变化。方法:ⅢA型前列腺炎患者228例,应用抗生素及非甾体类消炎药治疗4周,测定患者治疗前、治疗结束后4周及8周的血PSA水平及F-PSAR,分析治疗前后血PSA水平及F-PSAR的变化。结果:在228例ⅢA型前列腺炎患者中,血PSA治疗前为(3.51±3.03)μg/L,治疗后第4周为(2.75±2.84)μg/L,较治疗前显著下降(P<0.05);而F-PSAR由治疗前0.25±0.05升至0.27±0.03。其中PSA≥4μg/L的患者占28.5%(65/228),在PSA≥4μg/L的患者中,PSA由治疗前(6.24±1.93)μg/L降至治疗结束后第4周(4.58±2.99)μg/L(P<0.05),PSA下降的幅度为(32.9±36.1)%;治疗后PSA<4μg/L患者占27.7%(18/65),F-PSAR由治疗前(16±9)%升至治疗结束后第4周(22±11)%(P<0.05),F-PSAR上升幅度为(51.4±25.8)%。上述指标在治疗后4周和治疗后8周差异无显著性(P>0.05)。结论:慢性前列腺炎亦是血PSA升高的原因之一。在明确前列腺炎的诊断后,可以给予有效的抗感染及抗炎治疗,能显著降低血PSA水平及提高F-PSAR。     

选择性绿激光治疗前列腺增生症患者血清游离/总前列腺特异性抗原的变化

目的观察经尿道选择性绿激光前列腺汽化术(PVP)治疗前列腺增生症(BPH)患者,血清中的总前列腺特异性抗原(T-PSA)、游离PSA(F-PSA)水平和总/游离(F/T)PSA比值的变化,探讨其在PVP术后随访中的意义。方法对120例BPH患者行PVP治疗,采用化学发光免疫法分别检测术前1h、术后24h和1个月患者血清中的总PSA和游离PSA水平,并计算游离/总PSA比值,随访比较分析手术前后PSA变化差异。结果术后24h患者血清总PSA值平均为(15．5±8．4)μg/L及游离PSA值平均为(2．8±1．2)μg/L,均明显高于术前患者血清总PSA值(4．2±1．5)μg/L及游离PSA值(0．8±0．3)μg/L,差异有统计学意义(P＜0．05)。血清游离/总PSA比值术前术后比较差异无统计学意义(P＞0．05)。术后1个月血清总PSA值、游离PSA值及游离/总PSA比值与术前比较差异无统计学意义(P＞0．05)。结论与血清中的总PSA和游离PSA水平相比,血清游离/总PSA比值是PVP术后短期及长期随访的一个更可靠指标。     

前列腺炎患者前列腺按摩液320例病原体分析及其与血清PSA的关系

目的:分析前列腺按摩液病原体感染及药敏情况,并探讨其与血清前列腺特异性抗原(PSA)的相关性,为系统、规范地诊断和治疗前列腺炎提供依据。方法:320例前列腺炎患者,每例采集前列腺按摩液并一式3份:其中1份做细菌培养及鉴定,另1份做支原体培养及药敏,第3份用胶体金法测衣原体。在采集前列腺按摩液前抽取静脉血供PSA检测。结果:320例前列腺按摩液标本,分离出病原菌244株,其中细菌188株,以葡萄球菌为主;支原体和衣原体44株,以解脲脲原体(UU)为主。革兰阳性球菌对万古霉素、利奈唑烷较敏感;UU主要对交沙霉素和强力霉素敏感;病原菌培养阳性组的血清PSA水平[(6.98±0.56)μg/L]较阴性组[(2.32±0.12)μg/L]明显升高,差异有统计学意义(P0.05)。结论:前列腺炎可引起血清PSA水平升高,其感染的病原体对不同的抗菌谱耐药性差异很大,应在正确的病原学诊断和药敏试验指导下,选择合适以及个性化的抗生素治疗方案。     

Changes in serum prostate-specific antigen following prostatectomy in patients with benign prostate hyperplasia

PURPOSE: To investigate how prostatectomy for patients with benign prostate hyperplasia (BPH) affected the serum prostate-specific antigen (PSA) levels. METHODS: In 193 patients who underwent prostatectomy for BPH, serum PSA levels were measured before and three months after the operation. The total prostate weight measured by transrectal ultrasonography (TRUS) and the weight of the surgical specimen were examined in relation to the pretreatment PSA value and the changes in PSA levels after the operation. RESULTS: The transition zone volume measured by TRUS could well estimate the weight of the surgical specimen in patients who underwent subcapsular prostatectomy and transurethral resection of the prostate. The concentration of preoperative serum PSA showed a significant correlation with the prostatic volume and with the transition zone volume. Removal of 1 g of BPH tissue reduced serum PSA levels by an average of 0.18 ng/mL. The change in serum PSA levels after the prostatectomy correlated with the total prostatic gland volume and with the transition zone volume. CONCLUSIONS: The elevated PSA levels in patients with BPH were caused by the enlargement of the transition zone. After the resection of the adenoma, PSA levels should be expected to decrease to the normal range.     

良性前列腺增生中的高度前列腺上皮内瘤初步观察

本文观察良性前列腺增生（BPH）中的高度前列腺上皮内瘤（HPIN）现象。回顾性分析54例分析耻骨上前列腺摘除术患者的前列腺标本切片。统计其中HPIN的发生率,并结合患者术前PSA值,分别HPIN与非HPIN之间的血PSA值差别。结果发现54例患者中22例有HPIN表现,占总数的40．7％。HPIN组与非HPIN组之间的血PSA值无显著性差异。在本组BPH患者中,HPIN表现占有一定比例,因此认为HPIN现象并非前列腺癌（Pca）专用。本组中HPIN比例偏高与患者平均年龄较大有关。本研究通过血PSA测定尚无法简单区分HPIN和非HPIN。对于HPIN现象,一方面应提高警惕,密切随访;另一方面也不必盲目悲观,毕竟HPIN只是一种前列腺癌的前驱表现,而并不等于同于前列腺癌。     

Relationship between serum prostate specific antigen and histological prostatitis in patients with benign prostatic hyperplasia

The relationship between the serum values of prostate specific antigen (PSA) and the extent of histological prostatitis was investigated in 42 patients undergoing transurethral resection of the prostate for benign hyperplasia (BPH) without clinical evidence of prostatitis. Histological prostatitis was divided into three groups: acute, chronic-active, and chronic-inactive inflammation. The extent of histological prostatitis was expressed as the number of prostatic acinar and ductal glands with inflammatory infiltrate per total number of glands (%). The serum PSA values significantly correlated with the extent of acute and chronic-active prostatitis (correlation coefficient r = 0.765 and 0.656, P < 0.01). A relationship between PSA values and the extent of chronic-inactive prostatitis was not found. In the immunohistochemical study, prostatic epithelial cells with acute and chronic-active inflammation showed negative staining for PSA antigen. These results indicate that histological acute and chronic-active prostatitis is considered an important factor for inducing the high increase in serum PSA values via the leak phenomenon. © 1994 Wiley-Liss, Inc.     

血清PSA、游离PSA与良性前列腺增生临床的相关性研究

目的分析血清前列腺特异性抗原(PSA)及游离前列腺特异性抗原(fPSA)与良性前列腺增生(BPH)临床的相关性。方法应用化学发光微粒子免疫分析法(CMIA)对BPH患者血清PSA、fPSA进行检测。结果入选的40例患者病理均为BPH。PSA>4ng/ml者,术后随访1～3个月,平均2.5个月,PSA值均降至0.02ng/ml以下,可除外前列腺癌(PCa)病例。PSA<4ng/ml者16例(40%),4～10ng/ml者14例(35%),>10ng/ml者10例(25%);fPSA>0.934ng/ml者22例(55%)。血清PSA、fPSA水平与前列腺总体积(PV)、前列腺移行区体积(TZV)、年龄及国际前列腺症状评分(IPSS)呈正相关。结论本组血清fPSA与PV、TZV、年龄、IPSS评分有更强相关性。BPH患者血清PSA、fPSA水平升高的相关因素与前列腺总体积及移行区增大、高龄及高IPSS评分有关。     

前列腺增生患者前列腺液白细胞数量与血清PSA含量的关系

目的探讨前列腺增生患者前列腺按摩液（EPS）中白细胞含量与血清前列腺特异性抗原（PSA）升高之间的关系。方法 ELISA法测定78例前列腺增生患者的血清PSA含量,术前通过前列腺按摩获取前列腺液,并行前列腺液中的白细胞计数。分析EPS中白细胞含量与血清PSA升高的相关性,并比较不同血清PSA水平间（〈4ng/mL、4~10ng/mL、≥10ng/mL）的EPS中白细胞含量差异。结果前列腺增生患者血清PSA与EPS中白细胞密度和总数呈正相关关系,血清PSA升高组EPS中白细胞含量明显高于血清PSA正常组。结论前列腺增生患者血清PSA与EPS中白细胞的含量呈正相关,前列腺增生患者的PSA值增高可能与前列腺液中的白细胞增高有关。     

Correlation between serum prostate specific antigen and prostate volume in Taiwanese men with biopsy proven benign prostatic hyperplasia

PURPOSE: We studied the correlation between serum prostate specific antigen and the volume of different zones of the prostate in Taiwanese men with biopsy proven benign prostatic hyperplasia. MATERIALS AND METHODS: A total of 233 patients with a mean age of 71.4 years (range 42 to 89), serum prostate specific antigen less than 10 ng/ml and pathologically confirmed benign prostatic hyperplasia were enrolled in this study. Total prostate and transitional zone volumes were measured with transrectal ultrasonography. Peripheral zone volume was determined by subtracting transitional zone volume from total prostate volume. Correlations between patient age, total serum prostate specific antigen and the volume of each prostate zone were analyzed with the Pearson correlation coefficient. A linear regression model was used to determine the relationship between prostate specific antigen and prostate volume. The prostate specific antigen-prostate volume relationship in our patients was compared with published data on white and Japanese men. RESULTS: Age did not significantly correlate with serum prostate specific antigen and prostate volume. Serum prostate specific antigen significantly correlated with the volume of each prostate zone. After log transformation the Pearson correlation coefficient between total prostate specific antigen and the volume of the whole prostate gland, the transitional zone and the peripheral zone were 0.369, 0.377 and 0.272, respectively (p <0.001). Taiwanese men had lower prostate volume per unit prostate specific antigen comparing with white men, while the prostate specific antigen-total prostate volume relationship between Taiwanese and Japanese men was similar. CONCLUSIONS: In Taiwanese men with biopsy proven benign prostatic hyperplasia the volume of each prostate zone has significantly correlates with serum prostate specific antigen. The prostate specific antigen-total prostate volume relationship in Taiwanese men is different from that in white men. However, the prostate specific antigen-total prostate volume relationship between Taiwanese and Japanese men is similar.     

Effects of Bowman-Birk inhibitor concentrate (BBIC) in patients with benign prostatic hyperplasia

BACKGROUND: The Bowman-Birk inhibitor is a soybean-derived protease inhibitor that has anti-inflammatory and anticarcinogenic activities. METHODS: A Phase I trial of Bowman-Birk inhibitor concentrate (BBIC) in 19 male subjects with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) has been performed. RESULTS: The results of the trial indicated that there was no dose-limiting toxicity of BBIC. There was a statistically significant decrease in serum PSA levels in all BBIC-treated patients. Some BBIC-treated patients exhibited a relatively large reduction in serum PSA levels, ranging up to a 43% reduction. There was also a statistically significant decrease in serum triglyceride levels and a decrease in prostate volume in the treated patients. The scores recorded in response to a urinary symptom questionnaire indicated improved urinary activities in the BBIC-treated patients; however, the control subjects exhibited similar improvements in urinary activities during the course of the trial. CONCLUSIONS: The data obtained in this trial, particularly the data suggesting that BBIC treatment may lead to reduced serum PSA levels and reduced prostate volumes, suggest that a Phase II clinical trial of BBIC for the therapy of BPH is warranted.     

前列腺增生症中血管内皮生长因子C的表达与血清前列腺特异抗原的相关性

目的探讨不同前列腺特异抗原(PSA)水平组的前列腺组织中血管内皮生长因子C(VEGF-C)的表达有无差异,VEGF-C与PSA、前列腺体积等有无相关性等,为目前临床上常用的PSA分组方法提供依据或提出新的见解。方法收集本院2011年6月至2013年6月住院的前列腺增生症(BPH)患者150例,术前测定血清PSA值,根据总PSA(tPSA)及PSA比值(f/tPSA)分为5组,术后获取前列腺组织,用免疫组化法检测VEGF-C的表达情况。结果在全部组织中,VEGF-C阴性、弱阳性、阳性表达率分别为17.3%、55.3%和27.4%。各PSA组间表达差异有显著性意义,其表达水平与年龄无关,与前列腺体积、血清总PSA及PSA密度呈正相关。结论 VEGF-C可促进前列腺组织增生,从而促进血清PSA分泌,前列腺组织中VEGF-C的表达可作为预测前列腺术后复发及恶变几率的指标之一。     

手术治疗的良性前列腺增生患者年龄与血清PSA、PSAD的关系分析

目的探讨手术治疗的良性前列腺增生（BPH）患者年龄与血清前列腺特异性抗原（PSA）及前列腺特异性抗原密度（PSAD）的关系。方法选取手术治疗的BPH患者共369例,按年龄段分为4组,对其血清PSA进行检测,并计算PSAD值,分析年龄和血清PSA、PSAD的关系。结果随年龄的增长,手术治疗的BPH患者PSA呈现逐渐增加趋势;而PSAD在各组间基本保持不变。结论手术治疗的BPH患者血清PSA值与患者年龄有显著的相关性,而PSAD却相对保持恒定。     

血清PSA与良性前列腺增生临床病理的相关性研究

目的分析血清前列腺特异性抗原(PSA)与良性前列腺增生(BPH)临床病理的相关性。方法回顾性分析561例有下尿路梗阻症状经手术治疗后病理诊断为BPH的患者资料。年龄(68.3±6.3)岁,术前国际前列腺症状评分(IPSS)21.1±7.4,生活质量评分(QoL)4.5±0.8,尿流率(7.3±3.3)ml/s,前列腺体积(69.8±36.8)ml,剩余尿(81.9±105.8)ml,血清PSA值＜4 ng/ml者247例(44.0%),4～10 ng/ml者223例(39.8%)、＞10 ng/ml者91例(16.2%)。结果血清PSA水平与患者年龄、IPSS、QoL、最大尿流率、剩余尿量无明显相关性(r=0.08、0.03、0.06、0.04、0.09,P＞0.05),而与前列腺体积呈显著正相关(r=0.42,p＜0.01)；血清PSA水平升高与前列腺体积(F=93.45,P＜0.05)及尿潴留发生率(x~2=59.1,P＜0.01)间有统计学意义。BPH组织标本中以腺体增生为主(x~2=16.14,P＜0.01)或伴有梗死病灶(x~2=36.06,P＜0.01)患者的血清PSA水平明显升高。结论50%以上接受手术治疗的BPH患者血清PSA水平升高,前列腺体积增大、尿潴留以及表现为腺体增生为主或伴有梗死灶的BPH是血清PSA水平升高的主要原因。