50岁以下前列腺穿刺73例临床病理分析

发布时间：2018-04-02 06:07

本文选题：前列腺穿刺　切入点：前列腺特异抗原　出处：《浙江大学》2014年硕士论文

【摘要】：目的：探讨分析50岁以下年轻男性前列腺穿刺的临床病理特点。方法：通过收集73例50岁以下在我院行前列腺穿刺患者的年龄、PSA值、游离PSA值、前列腺体积、DRE、TRUS、MRI结果等数据,回顾性分析50岁以下年轻男性前列腺穿刺的临床病理特点。结果：73例病人中前列腺癌共19例(26.03%),前列腺增生46例(63.01%),前列腺炎症8例(1096%)。9例DRE异常的病例中诊断为前列腺癌的5例(55.56%),前列腺增生者4例(44.44%)。在前列腺癌与前列腺增生组之间PSA值、PSAD值差异具有统计学意义,而前列腺癌与前列腺炎组之间PSA值与PSAD值均无统计学差异。前列腺增生组PSA多位于4-10ng/ml (24例,52.2%),与其他两组相比差异有统计学意义,前列腺癌组PSA均4ng/ml,大多10ng/ml (16例,84.21%)。PSA位于4-10ng/ml时前列腺癌穿刺阳性率9.68%,PSA位于10.1-20ng/ml时,前列腺癌穿刺阳性率25.00%, PSA20ng/ml时前列腺癌穿刺阳性率为68.75%。而在剔除病理诊断为前列腺炎患者后,其穿刺阳性率分别为11.11%、27.78%、78.57%。随着PSA的升高,前列腺癌穿刺阳性率明显增加,同时高危Gleason评分(Gleason≥8分)的比例也明显增加。结论：在50岁以下中青年患者中,PSA值及PSAD值在前列腺增生及前列腺癌之间鉴别具有统计学意义。中年青患者中,不同PSA值的前列腺癌诊断率明显不同。在PSA值位于4-10ng/ml之间时,穿刺阳性率可能低于全年龄段穿刺阳性率,把握穿刺指征时应更慎重,应结合其他危险因素进行综合分析,而PSA10ng/ml时,穿刺阳性率基本同全年龄段阳性率,应考虑进行前列腺穿刺。
[Abstract]:Objective: To investigate the clinicopathological features of prostatic puncture in young men under 50 years of age.
Methods: by collecting data from 73 patients under 50 years old in our hospital, the age, PSA value, free PSA value, prostate volume, DRE, TRUS and MRI data of prostate biopsy patients were retrospectively analyzed, and the clinicopathological characteristics of prostate biopsy for young men under 50 years old were retrospectively analyzed.
Results: 73 cases of patients with prostate cancer in 19 cases (26.03%), 46 patients with benign prostatic hyperplasia (63.01%), 8 cases of prostatitis (1096%) cases of.9 patients with abnormal DRE in the diagnosis of 5 cases of prostate cancer (55.56%), 4 cases of benign prostatic hyperplasia (44.44%). The PSA value between prostate cancer and prostatic hyperplasia group, was statistically significant difference in PSAD values, and between prostate cancer and prostatitis group PSA showed no statistical difference value and PSAD. Located in 4-10ng/ml PSA prostatic hyperplasia group (24 cases, 52.2%), compared with the other two groups had significant difference between the prostate cancer group PSA were mostly 4ng/ml, 10ng/ml (16 in 84.21% cases,.PSA in 4-10ng/ml) the positive rate of prostate cancer puncture 9.68%, PSA is located in 10.1-20ng/ml, the positive rate of prostate puncture was 25%, PSA20ng/ml positive rate of prostate cancer biopsy for 68.75%. in removing pathological diagnosis of prostatitis patients after the positive biopsy Rates were 11.11%, 27.78%, 78.57%. with the increase of PSA, the positive rate of prostate cancer was significantly increased, while high Gleason score (Gleason = 8 points) the proportion also increased significantly.
Conclusion: at the age of 50 young patients, PSA and PSAD values between benign prostatic hyperplasia and prostate cancer to identify statistically significant. Young patients, the diagnosis of prostate cancer with different PSA values was significantly different. The PSA value in 4-10ng/ml, the positive rate of puncture may be lower than the positive biopsy rate in all ages, grasp the puncture indications should be more careful, should be combined with other risk factors were analyzed, and PSA10ng/ml, the positive rate of puncture is basically the same as all ages of the positive rate of prostate biopsy should be considered.

【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.25

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