HGPIN患者血清PSA特征及首次穿刺活检HGPIN阳性针数对再次活检PCa检出率的影响

目的 探讨高级别前列腺上皮内瘤(high grade prostatic intraepithelial neoplasia,HGPIN)患者血清前列腺特异性抗原(prostate specific antigen,PSA)特征及首次穿刺活检HGPIN阳性针数对再次活检前列腺癌(PCa)检测率的影响.方法 选取2013年2月至2015年12月在本院行前列腺穿刺的患者共320例,均行直肠超声引导下前列腺穿刺活检,分析各类患者血清PSA差异,对结果为非PCa患者于6个月后再次穿刺活检.结果 320例患者首次穿刺活检病理结果显示:其中HGPIN患者80例(孤立型51例,多灶型29例),低级别前列腺上皮内瘤(LGPIN)患者45例,前列腺增生(BPH)患者128例,PCa患者67例;其中PCa患者血清PSA为35.20(13.01,60.55) ng/mL,明显高于BPH、LGPIN、孤立型和多灶型HGPIN患者(P＜0.05);多灶型HGPIN血清PSA为12.15(6.82,16.43) ng/mL,明显高于BPH、LGPIN、孤立型HGPIN患者(P＜0.05);BPH、LGPIN、孤立型HGPIN患者血清PSA比较差异无统计学意义(P＞0.05);多灶性HGPIN患者再次穿刺为PCa的比例为38.46％ (10/26),明显高于BPH、LGPIN和孤立型HG-PIN患者(P＜0.05);BPH、LGPIN和孤立型HGPIN再次穿刺为PCa的比例比较差异无统计学意义(P＞0.05).结论 多灶型HGPIN血清PSA水平高于孤立型HGPIN、BPH以及LGPIN,但低于PCa;多灶型HGPIN患者再次活检PCa的检出率显著高于其他患者.

Characteristics of serum PSA in HGPIN patients and the effect of the number of the first time biopsy HGPIN positive needles on the detection rate of second biopsy PCa

Objective To investigate characteristics of serum prostate specific antigen (PSA) in HGPIN patients and the effect of the number of the first time biopsy high grade prostatic intraepithelial neoplasia (HGPIN) positive needles on the detection rate of secondary biopsy prostate cancer (Pca).Methods A total of 320 patients who underwent prostate biopsy in our hospital from February 2013 to December 2015 were selected.Ultrasound guided prostate biopsy was performed in all patients,and the differences of serum PSA was analyzed,non Pca patients after 6 months of treatment underwent the secondary biopsy.Results All patients for the first time biopsy results showed:80 patients with HGPIN (51 cases of solitary type and 29 cases of multifocal type),45 cases of low grade prostatic intraepithelial neoplasia (LGPIN),128 cases of benign prostatic hyperplasia (BPH),67 cases of Pca.Serum PSA of patients with Pca was significantly higher than that of BPH,LGPIN,solitary and multifocal HGPIN patients (P ＜ 0.05).Serum PSA of multifocal HGPIN was significantly higher than that of BPH,LGPIN and solitary HGPIN patients (P ＜ 0.05).There was not statistically significant difference in serum PSA among the BPH,LGPIN,solitary HGPIN patients (P ＞ 0.05).Pca proportion of secondary biopsy in multifocal HGPIN patients was 38.46％,significantly higher than BPH,LGPIN and solitary HGPIN patients (P ＜ 0.05).Pca proportion of secondary biopsy in BPH,LGPIN and solitary HGPIN patients was not statistically significant difference(P ＞ 0.05).Conclusions Serum PSA level of multifocal HGPIN patients is higher than solitary HGPIN,BPH and LGPIN,but still lower than Pca.Detection rates of secondary biopsy Pca in multifocal HGPIN patients are significantly higher than other patients.