前列腺腺癌患者血清PSA水平对Gleason评分的预测价值

目的探讨前列腺腺癌患者血清前列腺特异性抗原(PSA)水平对Gleason评分的预测价值。方法研究血清PSA三种主要指标和Gleason分级主要指标均值;比较不同组别之间的差异,分析血清PSA与Gleason评分相关性,并观察血清总PSA(tPSA)与Gleason评分之间变化趋势。结果血清tPSA≤4.0、4.1~10.0、10.1~20.0、20.1~100.0、100.0ng/mL组Gleason评分均值分别为6.31±0.47、6.66±0.89、7.04±1.11、7.56±1.03以及7.91±1.01;血清游离PSA(fPSA)≤1.0、1.1~10.0、10.0组Gleason评分均值分别为6.45±0.69、6.98±0.98以及7.75±1.05;血清总PSA(tPSA)t/fPSA≤0.16、0.17~0.50以及0.50组Gleason评分均值分别为6.72±0.88、7.45±1.04以及8.36±1.12。血清tPSA、fPSA以及fPSA/tPSA比值分别与Gleason评分、主要分级以及次要分级显著正相关;Gleason评分、主要分级以及次要分级均随血清tPSA、fPSA以及fPSA/tPSA逐渐增加而增加。结论前列腺腺癌患者血清PSA对Gleason评分的具有预测价值;与fPSA和fPSA/tPSA比值相比,tPSA是最有预测价值的指标。

The predictive value of serum PSA to Gleason score in patients with prostate adenocarcinoma

Objective To investigate the predictive value of the Gleason score to serum prostate specific antigen （PSA） in patients with prostate adenocarcinoma. Methods The mean level of 3 major indicators of serum PSA and Gleason score were studied and compared, the correlation between serum PSA and Gleason score was analyzed, and changes of serum PSA and G1- eason score were observed. Results When serum tPSAwas≤ 4.0, 4.1-10.0, 1-20.0, 20.1-100.0 and〉100.0 ng/mL, the average Gleason score was 6.31±0.47, 6.66±0.89, 7.04±1.11, 7.56±1.03 and 7.91±1.01. When serum fPSA was 1.0, 1.1-5.0, 〉5.0 ng/mL, the average Gleason score was 6.45± 0.69, 6.98± 0.98 and 7.75±1.05. When serum fPSA/tP- SA≤0.16, 0.17-0.50 and〉0.50, the average Gleason score was 6. 72± 0.88, 7.45±1.04 and 8.36±0.50. The serum t PSA, fPSA and fPSA/tPSA were significantly positively related to Gleason score, the primary grade and secondary grade. Oonclu- sions The serum PSA was useful to predict Gleason score in patients with prostate adenocarcinoma. Compared with fPSA and t/fPSA, tPSA is the most usefully predictive indicator.