血清PSA及超声引导穿刺活检对前列腺癌病理分期预测价值研究

目的 研究血清前列腺特异性抗原(PSA)及超声引导穿刺活检对前列腺癌病理分期的预测价值.方法 选取200例经直肠超声引导前列腺穿刺活检确诊为前列腺癌的患者的临床资料进行研究.分析患者的血清PSA、穿刺活检阳性百分数及Gleason评分3个参数与前列腺癌病理分期的相关性;同时对比性分析以上3个参数在不同病理分期前列腺癌患者中的差异情况.结果 血清PSA、穿刺活检阳性百分数及Gleason评分均与前列腺癌患者的病理分期呈正相关(P﹤0.001);D期前列腺癌患者的血清PSA水平明显高于A期、B期、C期前列腺癌患者(P﹤0.05),而A期、B期、C期前列腺癌患者的血清PSA水平两两之间比较,差异均无统计学意义(P﹥0.05);C期与D期前列腺癌患者的穿刺活检阳性百分数比较,差异无统计学意义(P﹥0.05),而其他各分期间穿刺活检阳性百分数两两比较,差异均有统计学意义(P﹤0.05);A期与C期、B期与C期、A期与D期、B期与D期前列腺癌患者的Gleason评分比较,差异均有统计学意义(P﹤0.05),而A期与B期、C期与D期前列腺癌患者的Gleason评分比较,差异无统计学意义(P﹥0.05).结论 血清PSA、穿刺活检阳性百分数及Gleason评分均可单独用于前列腺期病理分期的预测,同时该3个参数在区分前列腺癌病理分期方面也发挥一定辅助作用.

Study on the predictive value of serum PSA and ultrasound guided biopsy in pathological staging of prostate cancer

Objective To investigate the predictive value of serum prostate specific antigen (PSA) and ultrasound-guided biopsy for pathological staging of prostate cancer. Method The clinical data of 200 cases of prostate cancer diag-nosed by transrectal ultrasound guided prostate biopsy were studied. The correlation between serum PSA, percentage of positive biopsy, Gleason score and the pathological staging of prostate cancer was analyzed;at the same time, a compara-tive analysis was performed for the above 3 parameters in different pathological stages in prostate cancer patients. Result The serum levels of PSA, percentage of positive biopsy and Gleason score were positively correlated with the pathologi-cal staging of prostate cancer (P<0.001);the level of serum PSA in patients with prostate cancer in stage D was signifi-cantly higher than those in stage A, B and C (P<0.05), and there were no significant difference observed in regard of the serum PSA among patients with stage A, B, and C disease (P>0.05);the percentage of positive biopsy of prostate cancer in patients with stage C and D was of no statistically significant difference (P>0.05), while it was different among other stage of diseases (P<0.05);the Gleason score was significantly different between stage A and C, B and C, A and D, as well as B and D (P<0.05), and was similar between stage A and B, and C and D (P>0.05). Conclusion Serum PSA, per-centage of positive biopsy and Gleason score can be independently used for the prediction of pathological stages of pros-tate stage. At the same time, these 3 parameters may contribute to the distinguishing of pathological stages.