PSA、PSAD和PSAT在前列腺穿刺活检中的价值

目的 研究血清前列腺特异性抗原(PSA)及其密度(PSAD)和移行带密度(PSAT)在前列腺穿刺活检中的价值.方法 选取本院2014年5月至2015年5月收治的150例患者进行前列腺穿刺活检,分析并比较PSA、PSAD、PSAT在前列腺穿刺活检中的差异及其在确诊疾病方面的价值.结果 在前列腺穿刺活检的150例中发现PSA＜4 ng/mL有8例,4 ng/mL≤PSA≤20 ng/mL有66例,PSA ＞20 ng/mL有76例.其中在PSA＜4 ng/mL的8例中,活检结果良性前列腺增生6例,前列腺小细胞癌1例,前列腺横纹肌肉瘤1例.在4 ng/mL≤PSA≤20 ng/mL的66例中,活检结果诊断为前列腺癌增生患者54例,活检阳性率为81.8％,PSA平均值为(13.98±1.51) ng/mL,PSAD平均值为(0.32±0.18);PSAT平均值为(0.35±0.18);活检前列腺癌12例,活检阳性率为19.2％,PSA平均值为(14.29±1.48) ng/mL,PSAD平均值为(0.42±0.15),PSAT平均值为(0.82±0.15);将其分为良性前列腺增生组和前列腺癌组,两组差异具有统计学意义(P＜0.05).当PSAD ＞0.13或PSAT＞ 0.15时,前列腺癌的敏感性分别为92.86％和96.94％.在PSA＞ 20 ng/mL的76例中,前列腺癌有68例,活检阳性率89.47％.结论 在4 ng/mL≤PSA≤20 ng/mL时,PSAD和PSAT对前列腺增生和前列腺癌的鉴别诊断具有重要意义,其中又以PSAT更为准确;PSA＞ 20ng/mL时,应高度怀疑前列腺癌,及时确诊治疗.

PSA,PSAD and PSAT value in prostate biopsy

Objectives To study the serum prostate specific antigen (PSA) and its density (PSAD) and density of the transitional belt (PSAT) in the value of biopsy of the prostate.Methods One hundred and fifty patients with prostate biopsy were selected in the hospital from May 2014 to May 2015.PSA,PSAD and PSAT differences in prostate biopsy and its value in diagnosis of the disease were analyzed and compared.Results Among the 150 cases with prostate biopsy,PSA ＜ 4 ng/mL in 8 cases,4 ng/mL≤PSA≤20 ng/mL in 66 patients,PSA ＞ 20 ng/mL in 76 cases were found.Among the 8 cases(PSA ＜ 4 ng/mL),6 cases of benign prostatic hyperplasia,1 case of small cell carcinoma of prostate,1 case of prostate rhabdomyosarcoma were found.In 66 cases(4 ng/mL≤PSA≤20 ng/mL),54 cases diagnosed as benign prostatic hyperplasia in 54 cases,biopsy positive rate was 81.8％,the average PSA was (13.98 ± 1.51) ng/mL,PSAD average was 0.32 ±0.18,average of PSAT was 0.35 ± 0.18.12 cases were taken biopsy of the prostate carcinoma,the biopsy positive rate was 18.2％,the average PSA was (14.29 ± 1.48) ng/mL,PSAD average was 0.42 ± 0.15,average of PSAT was 0.82 ± 0.15.All patients were divided into benign prostatic hyperplasia group and prostate cancer group,there were statistically significant differences between the two groups(P ＜ 0.05).When PSAD ＞ 0.13 or PSAT ＞ 0.15,the sensitivity of prostate cancer was 100％.In 76 cases (PSA ＞ 20 ng/mL),68 cases of prostate cancer,the biopsy positive rate was 89.47％.Conclusions When 4 ng/mL≤PSA ≤ 20 ng/mL PSAD and PSAT to the differential diagnosis of prostatic hyperplasia and prostate cancer have the important? meaning,and PSAT is more accurate.When PSA ＞ 20 ng/mL,it should be highly suspected prostate cancer with timely diagnosis and early treatmem.