前列腺增生与PSA前列腺组织炎症的相关性研究

目的:探讨良性前列腺增生(benign prostatic hyperplasia,BPH)患者前列腺组织炎症、前列腺特异性抗原(prostate specific antigen,PSA)与BPH的临床进展的相关性.方法:选择我院2008年2月至2011年2月在泌尿外科行经尿道前列腺电切术170例、耻骨上前列腺切除术65例、保留尿道前列腺切除术72例共307例的良性前列腺增生患者的前列腺组织标本进行病理分析(炎症分级)、B超检测前列腺体积以及应用化学发光微粒子免疫分析法(CMIA)检测患者血清PSA.分析PSA与前列腺组织炎症、国际前列腺症状评分(international prostate symptom score,IPSS)、前列腺体积、最大尿流率、残余尿量等的关系.结果:188例(占61.2％)前列腺组织标本存在炎症,以慢性腺周炎症为主.炎症组的患者年龄段小于非炎症组患者,而IPSS评分及前列腺体积则高于和大于非炎症组患者,两组各指标两两比较,差异均有统计学意义( P＜0.01-0.05)；采用Logistic多因素回归分析发现:高年龄段患者血清PSA水平较低年龄段患者PSA明显升高(P＜0.05),血清PSA水平与IPSS评分及前列腺体积呈正相关(r=0.21,0.61,P＜0.01-0.05)；前列腺组织炎症与血清PSA升高有关,两者呈显著正相关(r=0.42,P＜0.01)；血清PSA水平与最大尿流率及残余尿量无相关性(r=0.04,0.08,P＞0.05).结论:前列腺增生患者大部分伴有组织炎症,提示炎症可能在良性前列腺增生的临床进展过程中起重要作用.

Correlational Research on Prostatic Hyperplasia with PSA and Prostate Tissue Inflammation

Objective: To explore the correlation between patients’clinical progress of benign prostatic hyperplasia(BPH)and their prostate tissue inflammation and prostate specific antigen(PSA).Method:307 patients with BPH were chosen from urological surgery unit of our hospital between Feb.2008 to Feb.2011(170 patients underwent transurethral resection of prostate,65 patients underwent suprapubic prostatectomy,72 patients underwent Madigan’s prostatectomy.Samples of prostate tissue from patients with BPH were analysed pathologically(inflammation grading).B ultrasonic was performed to measure the prostatic volume and chemiluminescence micro particle immune process(CMIA) was applied to detect PSA of patients with BPH.The relationships between PSA and the prostatic tissue inflammation,international prostate symptoms score(IPSS),the prostatic volume,maximum urine flow rate and residual volume were analyzed.Result:Periglandular inflammation was found in 188(61.2%) prostatic tissue specimens.The patients with inflammation were younger than those in non-inflammatory groups,while their IPSS and prostatic volume were higher,there were statistically significant differences(P<0.01-0.05) in comparative analysis of each index in two groups.Compared with younger group(P<0.05),the multivariable logistic regression analysis found the level of serum PSA in elder group increased significantly.The level of serum PSA was positively correlated with IPSS and the prostatic volume(r = 0.21,0.61,P<0.01-0.05).Prostatic tissue inflammation was positively correlated with elevating serum PSA(r = 0.42,P<0.01).The level of serum PSA was unrelated with maximum urine flow rate and the quantity of residual urine(r = 0.04,0.08,P>0.05).Conclusion:A large number of the prostate hyperplasia patients have tissue inflammation,which suggests that inflammation has played an important role in the clinical developments of BPH