单中心前列腺穿刺活检结果查询表的建立

目的：综合利用PSA及其相关参数建立能够简便查询的前列腺穿刺阳性率查询表.方法纳入2009年7月至2015年3月在解放军总医院行前列腺穿刺活检的患者,收集前列腺体积、游离PSA(free PSA,fPSA)和总PSA(total PSA,tPSA)等临床资料.多因素Logistic回归分析预测前列腺癌的独立性影响因素,并利用相关因素建立前列腺穿刺阳性结果查询表.结果资料完整且病理结果为前列腺癌和前列腺增生的患者纳入研究,共1077例.根据PSA水平分为0~2.5、2.6~4.0、4.1~10.0、10.1~20.0和＞20.0 ng/ml 5组,前列腺癌检出率分别为20.9％、20.0％、37.3％、48.1％和80.2％,随着PSA水平的升高,前列腺癌检出率也明显升高.多因素Logistic回归分析发现tPSA、fPSA和前列腺体积均为前列腺癌的独立性预测因素,tPSA、fPSA百分比(free to total PSA,f/tPSA)和PSA密度(PSA density,PSAD)在前列腺癌和前列腺增生两组间存在显著差异(P＜0.05),综合利用上述3个指标建立前列腺阳性穿刺查询表.结论本研究根据 tPSA、f/tPSA和PSAD建立的查询表为临床前列腺穿刺活检提供了一个简便实用的阳性率查询工具.

Establishment of a look-up table for the result of prostate biopsy

Objective To develop a look-up table for the result of prostate biopsy based on prostate specific antigen (PSA)and related parameters. Methods We retrospectively analyzed the clinical data of patients who underwent prostate biopsy for diagnose prostate cancer in our hospital from July 2009 to March 2015. Variables including prostate volume,free PSA (fPSA)and total PSA (tPSA)were collected. We performed Logistic regression analysis to identify the independent risk factors related to positive prostate biopsy. Then we constructed a look-up table according to re-gression result to predict the result of prostate biopsy. Results 1 077 patients,presented with in-tegrity data,whose biopsy result were prostate cancer or benign prostate hyperplasia were enrolled in this study. We divided patients into five group:0-2.5,2.6-4.0,4.1-10.0,10.1-20.0 and>20 ng/ml according to tPSA levels,and the detection rate of prostate cancer each group were 20.9%,20.0%, 37.3%,48.1% and 80.2% respectively. FPSA,tPSA and prostate volume were independent risk factors by Logistic regression analysis. Significant difference between prostate cancer or benign pros-tate hyperplasia was noted in tPSA,free PSA/total PSA (f/tPSA)and PSA density (PSAD),which parameters we established look-up table based on. Conclusions The look-up table established based on tPSA,f/tPSA and PSAD can be used as a simple and practical tool for doctors to analyze condition and make decision.