血清PSA与前列腺癌病理分级临床分期相关性研究

目的：探讨前列腺癌患者血清PSA与前列腺癌病理分级和临床分期的相关性。方法：前列腺手术前检测PSA,术后经病理检查确诊为前列腺癌患者42例,根据苏木素－伊红染色切片中肿瘤的组织学形态,结合临床资料分别进行病理分级,临床分期,采用Spearman等级相关分析分析PSA与前列腺癌病理分级和临床分期的关系。结果：PSA值与前列腺癌的病理分级有关,与前列腺癌临床分期间的关系目前尚无肯定的结论。结论：PSA值不仅是前列腺癌的一个筛选指标,而且可能是判断前列腺癌预后的一个有意义的指标。     

血清PSA及PSA密度与前列腺癌分级分期的关系

目的：提高前列腺癌（PCa）的诊断水平。方法：回顾了60例经穿刺活检确诊PCa患者的临床资料。结果：60例PCa患者中,血清T—PSA含量、F-PSA含量、F／T分别与PCaGleason分级、临床分期均呈正相关,F／T与PCaGleason分级、临床分期均无显著相关。结论：PCa患者的血清T—PSA、F—PSA和PSAD与Gleason分级和临床分期存在相关,提示可能通过检测血清T—PSA、F-PsA和PSAD预测PCa恶性程度及预后,有利于PCa的筛查及制定合理的治疗方案。     

血清PSA、FPSAR与前列腺癌病理分级、临床分期的相关性研究

目的 :探讨前列腺癌病人血清前列腺特异抗原 (PSA)、血清游离前列腺特异抗原百分率 (FPSAR)与前列腺癌病理分级、临床分期的相关性。　方法 :分别检测经病理检查确诊为前列腺癌的 4 2例病人血清PSA、FPSAR ,并根据标本苏木精 伊红染色切片中肿瘤的组织学形态及临床资料对病人分别进行病理分级、临床分期。采用Spearman等级相关分析 ,分析PSA、FPSAR与前列腺癌病理分级、临床分期的关系。 　结果 :前列腺癌病人PSA值越高 ,癌症恶性程度越高 ,PSA值与前列腺癌病理改变呈明显正相关性 (P <0 .0 5 ) ,而与前列腺癌的临床分期无相关性 (P >0 0 5 ) ;前列腺癌病人FPSAR值与前列腺癌病理改变呈正相关 ,与病人临床分期呈负相关 (P <0 .0 5 )。结论 :与PSA值相比 ,FPSAR值预测前列腺癌的病理分级、临床分期和预后可能更为准确     

血清PSA、PSAD结合病理分级对前列腺癌骨转移的诊断价值

PCa是老年男性常见的恶性肿瘤之一,随着社会老龄化、人们生活方式的改变以及新的诊断技术的应用,近年来我国PCa的发病率呈显著上升趋势,由于PCa早期症状不太典型,故在首次就诊时约有2/3患者已有远处转移,尤其是骨转移[1].而准确的临床分期对于制定合理的治疗方案和判断预后有非常重要的意义.     

血清PSA值与穿刺标本Gleason评分预测前列腺癌病理分级

目的 探讨准确有效预测前列腺癌病理分级的方法.方法 分析75例前列腺癌患者术前血清PSA水平、穿刺活检标本和前列腺癌根治术后标本Gleason评分资料,对血清PSA水平与根治术后标本Gleason评分进行等级相关分析,对穿刺活检标本与根治术后标本Gleason评分进行配对秩和检验.结果 75例患者术前血清PSA值4～230 ng/ml,平均33.5 ng/ml;穿刺活检标本Gleason评分2～9分,平均(4.4±2.3)分;根治术后标本Gleason评分2～10分,平均(4.8±2.5)分.术前血清PSA水平与根治术后标本Gleason评分呈正相关(rs=0.279,P=0.015),穿刺活检标本与根治术后标本Gleason评分差异有统计学意义(P=0.011).结论 前列腺癌患者术前血清PSA水平越高,根治术后标本Gleason评分也越高;穿刺标本Gleason评分有低估的缺点,必要时应行病理分级后再评估.     

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。     

血清PSA正常的进展型前列腺癌2例报告

前列腺特异性抗原（prostatic specific antigen，PSA）是仅由前列腺上皮所分泌的一种酶，已被广泛应用于前列腺癌的早期诊断、治疗后监测肿瘤的复发和进展的一个有效简便的手段。但在1996～2004年，我科在临床上遇到2例前列腺癌患者甚至到死亡，PSA值始终是正常的。现报告如下。     

穿刺前列腺癌Gleason评分与血清PSA的相关性分析

目的:探讨穿刺前列腺癌Gleason评分与血清PSA水平的相关性。方法:收集我院2011年5月~2014年6月经前列腺穿刺确诊为前列腺癌且临床资料完整的患者标本81例,对其穿刺组织的Gleason评分与血清PSA水平进行Spearman等级相关性分析。结果:前列腺癌组织Gleason评分与患者血清PSA水平呈正相关(r=0.347,P0.01),PSA值越高,Gleason评分越高。结论:前列腺癌患者血清PSA水平与Gleason评分相关。     

PSA、PSAD和PSAT对前列腺癌诊断的比较

目的　比较前列腺移行带特异性抗原密度（PSAT）与前列腺特异性抗原（PSA）及前列腺特异性抗原密度（PSAD）在前列腺癌诊断中的意义。方法　对78例PSA4～20ng/ml的患者行前列腺穿刺活检后比较PSA、PSAD和PSAT指标。结果　78例中,病理诊断为前列腺癌(PCa)32例,良性前列腺增生(BPH)46例,二者PSA平均值分别为(14.32±1.46)ng/ml、(13.89±1.52)ng/ml,二者相比差别无显著性意义(P>0.05);PSAD平均值分别为0.43±0.14、0.36±0.17,二者相比差别有显著性意义(P<0.05);PSAT平均值分别为0.75±0.19、0.31±0.06,二者相比差别有非常显著性意义(P<0.01)。结论　PSAD和PSAT对预测PSA<20ng/ml的患者是否患前列腺癌有较大帮助,特别是PSAT更为准确。     

前列腺腺癌患者血清PSA水平对Gleason评分的预测价值

目的探讨前列腺腺癌患者血清前列腺特异性抗原(PSA)水平对Gleason评分的预测价值。方法研究血清PSA三种主要指标和Gleason分级主要指标均值;比较不同组别之间的差异,分析血清PSA与Gleason评分相关性,并观察血清总PSA(tPSA)与Gleason评分之间变化趋势。结果血清tPSA≤4.0、4.1~10.0、10.1~20.0、20.1~100.0、100.0ng/mL组Gleason评分均值分别为6.31±0.47、6.66±0.89、7.04±1.11、7.56±1.03以及7.91±1.01;血清游离PSA(fPSA)≤1.0、1.1~10.0、10.0组Gleason评分均值分别为6.45±0.69、6.98±0.98以及7.75±1.05;血清总PSA(tPSA)t/fPSA≤0.16、0.17~0.50以及0.50组Gleason评分均值分别为6.72±0.88、7.45±1.04以及8.36±1.12。血清tPSA、fPSA以及fPSA/tPSA比值分别与Gleason评分、主要分级以及次要分级显著正相关;Gleason评分、主要分级以及次要分级均随血清tPSA、fPSA以及fPSA/tPSA逐渐增加而增加。结论前列腺腺癌患者血清PSA对Gleason评分的具有预测价值;与fPSA和fPSA/tPSA比值相比,tPSA是最有预测价值的指标。     

Correlation of serum PSA and Gleason score in Nigerian men with prostate cancer

Objective  Prostate cancer is an important cause of morbidity and mortality worldwide. While the predisposing factors are not fully understood, African descent is an important risk factor, and prostate cancer has become the number-one cancer in Nigerian men. This was a retrospective study of the correlation between serum prostate specific antigen (PSA) and Gleason grade and score in patients of Nigerian descent. Patients and Methods  The University College Hospital (UCH) Ibadan Cancer Registry was used to identify and quantify the incidence of prostate cancers occurring between 1998 and 2000. The histological slides of appropriate cases were reviewed to confirm the Gleason grade and score. The serum PSA values were retrieved from the patients' case notes and laboratory files. The data obtained were subjected to statistical analysis to look for associations and correlations. Results  The study included 67 men with prostate adenocarcinoma and PSA measurements who were diagnosed and treated at the UCH Ibadan between January 1998 and December 2000. There was a positive correlation between serum PSA and Gleason grade, as well as between serum PSA and Gleason score in our cohort of Nigerian African men with prostate cancer. PSA levels were significantly lower in patients with stage B disease than in patients with stage D disease. Conclusion  Serum PSA is significantly higher in metastatic than in localized disease. Further studies are necessary to determine biomarkers that complement serum PSA and the Gleason grading system in the prognostication of prostate cancer in African patients.     

N-cadherin switching occurs in high Gleason grade prostate cancer

BACKGROUND: The inappropriate expression of non-epithelial N-(neural) cadherin by epithelial cells, called cadherin switching, has been suggested to play a role in prostate cancer (PC) progression. We explored the role of N-cadherin as a biomarker in PC by correlating the expression with clinical parameters. METHODS: Two pathologists blinded to patients' history independently reviewed and scored the intensity and extent of staining of N-cadherin expression in 44 randomly selected radical prostatectomy specimens. The expression was correlated with total Gleason grade, individual Gleason patterns, tumor stage, and preoperative serum prostate specific antigen (PSA) levels and P-values < 0.05 were considered statistically significant. RESULTS: Of the 44 PC specimens, 14 (32%), 23 (52%), 7 (16%) consisted of Gleason grade 5-6, 7, and 8-10, respectively and 20/44 (45%) demonstrated N-cadherin expression. N-cadherin was expressed in 1/14 (7%) of Gleason 5-6 compared to 15/23 (65%) of Gleason grade 7, and 4/7 (57%) of Gleason grade 8-10, demonstrating a significant correlation between N-cadherin switching and higher Gleason grade (P = 0.001). While only about a third of primary or secondary Gleason pattern 3 demonstrated N-cadherin expression, a majority of Gleason patterns of > or = 4 expressed N-cadherin (P > 0.05), further suggesting that N-cadherin switching occurs with higher Gleason pattern. However, N-cadherin expression did not significantly correlate with preoperative serum PSA levels or tumor stage in our study cohort. CONCLUSIONS: We have demonstrated for the first time that N-cadherin switching occurs in higher grade PC and correlates significantly with increasing Gleason patterns. N-cadherin may be as a useful biomarker of aggressive PC.     

Value of PSA density in carcinoma of the prostate

Summary The PSA density was calculated in 98 patients with carcinoma of the prostate by using the weight and/or volume of the radical prostatectomy specimen. In 22 of 98 patients, PSA serum levels ranged between 4 and 10 ng/ml. Eleven patients showed PSA serum levels below 4 ng/ml and 65 patients above 10 ng/ml. Sixty-one of the 65 patients with PSA serum levels > 10 ng/ml had PSAD values above 0.15, and we therefore suspected the presence of carcinoma of the prostate according to Benson et al. Twelve of the 22 patients with PSA serum levels between 4 and 10 ng/ml had PSAD values below the cut-off value of 0.15. In addition, all 11 patients with PSA values < 4 ng/ml showed PSAD values < 0.15, a range that can be regarded as almost harmless according to Benson et al. In conclusion, it seems apparent that in patients with PSA serum levels < 10 ng/ml, no important additional information is obtained from the PSAD determination. Routine measurement of PSAD for evaluating the risk of carcinoma of the prostate in individual cases can therefore not be recommended.      

精浆中PSA浓度与精液粘度关系的研究

ＰＳＡ是人体前列腺上皮细胞产生的外分泌物。在精液中，ＰＳＡ直接涉及到凝固精液的液化。从１９９３年１２月～１９９５年８月，对８５例精液标本进行ＰＳＡ和粘度测定。高粘度精液的ＰＳＡ平均浓度为０．２８±０．０２ｍｇ／ｍｌ，正常粘度精液的ＰＳＡ平均浓度为０．３９±０．０２ｍｇ／ｍｌ。结果显示：精浆中ＰＳＡ水平在高粘度病人中有意义地被降低，也提示：在人类精液中ＰＳＡ浓度与精液粘度是紧密相关的。     

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。     

前列腺癌血清PSAD与原位PSA的相关性研究

目的 :探讨前列腺癌患者血清前列腺特异抗原密度 (PSAD)与组织原位PSA表达的关系。方法 :参照Gleason标准对 2 5例前列腺腺癌组织进行分级 ,用免疫组织化学SP法检测前列腺癌组织中PSA ,术前 1周用化学发光分析法测定血清PSA浓度及经腹B超测定前列腺体积 ,二者之比为PSAD。结果 :5例高分化肿瘤全部呈强阳性 ;13例中分化肿瘤中 ,4例呈强阳性 ,9例呈弱阳性 ;7例低分化肿瘤中 ,1例呈强阳性 ,3例呈弱阳性 ,3例阴性。 2 5例腺癌PSAD为 0 .36～ 1.5 3(U =0 .75 )。不同分化的癌组织的PSA表达强度差异有显著性意义(P <0 .0 5 ) ,高、中分化组的血PSAD与低分化组差异有显著性意义 (P <0 .0 5 ) ,不同PSA表达强度的患者血PSAD差异无显著性意义 (P >0 .0 5 )。结论 :癌组织中蛋白酶的破坏造成PSA漏出增多 ,可能与血PSAD升高有关。癌组织PSA的免疫组织化学反应强度不能用于解释血PSAD的变化     

Comparison of clinical and pathological features in African-American and Caucasian patients with localized prostate cancer

OBJECTIVE: To examine patient characteristics, prostate specific antigen (PSA) levels, and established preoperative and pathological prognostic factors to determine differences between Caucasian and African-American patients with localised prostate cancer, as it remains controversial whether African-American men present with more aggressive disease. PATIENTS AND METHODS: One hundred consecutive patients (aged 53-76 years) undergoing radical retropubic prostatectomy (RRP) at an equal-access tertiary-care centre were retrospectively reviewed. All patients had preoperative PSA levels, a physical examination (including clinical staging), and sextant biopsy. Insurance information was also collected. The same urological oncologist determined clinical staging and performed all the RRPs, and the same genitourinary pathologist determined the Gleason grade for biopsies and surgical specimens, pathological stage, percentage of tumour involvement, and specimen weight. African-American and Caucasian patients were compared for PSA, clinical stage, pathological stage, biopsy and pathological Gleason grade, organ confinement, margin status and specimen weight. Using preoperative and pathological data, both groups were also compared for over- and under-staging and -grading. The Wilcoxon rank test with P < 0.05 was used to determine statistically significant differences. RESULTS: African-American patients were more likely to be Medicaid or self-insured than Caucasian patients. Age, biopsy grade and clinical stage were not significantly different between the groups. African-American patients presented with a mean PSA level of 11.9 ng/mL and Caucasians with a mean of 8.5 ng/mL (P = 0.03). When clinical and biopsy data were compared with pathological data there were no differences between the groups in under/over-grading or under/over-staging. African-American patients had larger prostates per surgical specimen than their Caucasian counterparts (59.3 g vs 51.6 g, respectively; P = 0.04). CONCLUSIONS: In a referred, equal-access system, African-American patients presented with higher serum PSA levels and had larger prostates in the surgical specimen. However, African-American patients did not present at an earlier age or with higher Gleason grade or clinical stage, nor were pathological grade and stages higher. Other pathological features were no different. African-American patients were not under- or over-staged or under- or over-graded more than their Caucasian counterparts. This retrospective study does not suggest that African-American men present with more aggressive disease.