血清PSA测定结合超声引导下经直肠前列腺穿刺活检诊断前列腺癌

目的通过测定血清总前列腺特异性抗原（T—PSA）、游离特异性抗原（F—PSA）及PSA密度（PSAD）的变化规律，结合超声引导下经直肠前列腺穿刺活检术，探讨PSA在前列腺癌诊断中的应用价值。方法男性患者共148例行血清PSA的测定，并行经直肠超声引导下的前列腺活检术，根据病理诊断结果将患者分为前列腺癌组、前列腺增生组及慢性前列腺炎组，并对各组数据予以统计分析。结果前列腺癌组T—PSA、F—PSA及PSAD值均显著高于前列腺增生及前列腺炎组，比较不同T—PSA浓度与前列腺癌发生率的关系表明，T—PSA〉10ng/ml时其前列腺癌的发生率显著高于4ng/ml〈T—PSA及4ng/ml〈T—PSA〈10ng/ml组，而前列腺增生和前列腺炎组间无显著差异。F/T—PSA比值在各组间比较无显著差异。结论血清T—PSA与F—PSA值在高危前列腺癌人群筛查中具有极大实用价值，实施经直肠超声引导下的组织活检术应作为确诊前列腺癌的主要手段。

Determination of serum PSA combined tissue biopsy under transrectal untrasound guidance in the diagnosis of prostate cancer

Objective This study was aimed to investigate the clinical significance of determination of serum total PSA(T-PSA),free PSA and PSA density(PSAD) in the diagnosis of prostate cancer when combined with tissue biopsy under guidance of tranrectal ultrasound.Methods The serum PSA level of totally 148 cases of patients were determined,furthermore,all these patients were also biopsied under the guidance of transrectal ultrasound.And,these patients were divided into three groups according to the tissue pathological results as prostate cancer group(Pca),benign prostate hyperplysia group(BPH) and chronic prostatitis group.Data from the above groups were statistically analyzed.Results The level of T-PSA,F-PSA and PSAD in Pca group were markedly higher than that of both BPH and CP group.When compared the relationship of different concentrations of T-PSA and the occurrence rate of Pca,we found that the occurrence rate of Pca was remarkably higher when T-PSA>10ng/ml,however,there were no significant difference in group BPH and CP.The ratio of F/T-PSA showed no significant differences between these three groups.Conlusion General determination of serum T-PSA and F-PSA is of great importance in those risky people,however,tissue biopsy under guidance of transrectal ultrasound should be considered as the leading method in the diagnosis of prostate cancer.