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 考察高级别前列腺上皮内瘤(HGPIN)患者血清前列腺特异抗原(PSA)特征和首次穿刺活检HGPIN阳性针数对再次活检前列腺癌(PCa)检出率的影响.方法 使用穿刺活检法对551例疑似为PCa患者进行诊断.依据诊断结果比较各组间血清PSA水平以及首次穿刺活检HGHN阳性针数组间再次活检PCa检出率.结果 活检结果显示37.0％(204/551)患者为PCa患者,43.6％(240/551)患者为良性前列腺增生(BPH),10.7％ (59/551)患者为低级别前列腺上皮内瘤(LGPIN),48例患者为HGPIN,其中阳性针数为1针者28例、2针者13例、3针及以上者7例.PCa、阳性针数为2针以上患者PSA水平显著高于BPH患者(P＜0.05).BHP患者复诊PCa检出率12.8％(6/47)、LGPIN患者10.3％ (3/29)、单灶HGPIN患者10.7％ (3/28)、双灶HGHN患者23.1％ (3/13)、三灶及以上HGPIN患者57.1％ (4/7).结论 单灶型HGPIN血清PSA水平较低,多灶型HGPIN血清PSA水平升高,且多灶型HGPIN再次活检时PCa检出率增加.

Features of serum PSA in HGPIN patients and the influencce of HGPIN positive needle biopsy unmber on the detection rate of PCa

Objectives To study features of serum prostate specific antigen (PSA) characteristics in high grade prostatic intraepithelial neoplasia (HGPIN) and the first needle biopsy HGPIN positive number on prostate cancer (PCa) detection rate.Methods 551 patients with suspected PCa were diagnosed by biopsy.According to the diagnostic results,the detection rate of PCa was compared between the serum PSA level of each group and the HGPIN positive needle array in the first time.Results Biopsy results showed that 37.0％ (204/551) of patients were PCa,43.6％ (240/551) of patients were benign prostatic hyperplasia (BPH) and 10.7％ (59/551) of patients were low grade prostatic intraepithelial neoplasia (LG PIN).In those 48 cases of HG PIN patients,28 cases were one positive needle,13 cases were two positive needles,7 cases were three or more positive neddles.Patients with PCa,two or more positive needles had significantly higher PSA level (P ＜ 0.05).The return visit of PCa detection rate were 12.8％ (6/47) in BHP patients.In LG PIN were 10.3％ (3/29),unifocal HGPIN patients were 10.7％ (3 / 28),bifocal HGPIN patients were 23.1％ (3 / 13),trifocal and above HGPIN patients were 57.1％ (4 / 7).Conclusions The level of serum PSA in unifocal HG PIN patients is low,and the level of PSA in the multi focal HGPIN is increased,and the detection rate of PCa is increased during the multiple HGPIN biopsy.