PSA对前列腺癌诊断价值的探讨

发布时间：2018-04-10 06:37

本文选题：PSA　切入点：F/T比值　出处：《大连医科大学》2014年硕士论文

【摘要】：目的：探讨PSA、F/T比值以及PSAD分别在前列腺癌的确定诊断中的价值。方法：本研究选取2005年7月至2012年8月经过前列腺穿刺活检和/或手术标本病理确诊的前列腺疾病患者共208例，分为前列腺癌组（恶性组）和良性前列腺增生组（良性组）；根据经直肠超声的结果分为有结节（阳性）组和无结节（阴性）组；根据结节回声特性分为低回声组和高（混合）回声组；检测血清中总PSA以及游离PSA、并计算F/T比值，TRUS测量前列腺的体积并计算PSAD值，，根据PSA（ng/ml）水平分为5组，PSA＜4、4≤PSA＜10、10≤PSA＜20、20≤PSA＜30和PSA≥30组，PSA（ng/ml）分别取4、10、20、30为临界值，F/T比值取0.16、0.18、0.20为临界值，PSAD（ng/ml/cm3）取0.15、0.25、0.35为临界值，比较各指标在不同临界值时预测前列腺癌的敏感度、特异度以及约登指数，探讨能够对前列腺癌确定诊断的最合适各项指标值。结果：前列腺癌患者的PSA值、PSAD值及低回声结节出现的比例均明显高于良性前列腺增生组（P值均＜0.01）；PSA（ng/ml）分别取4、10、20、30为临界值时预测前列腺癌的敏感度分别为94.03%、84.33%、67.16%、56.72%，特异度分别为31.08%、78.38%、93.24%、97.30%，约登指数分别为0.2571、0.6271、0.604和0.5402；F/T比值取0.16、0.18、0.20为临界值时预测前列腺癌的敏感度分别为71.64%、73.88%和76.87%，特异度分别为67.57%、64.86%和58.11%，约登指数分别为0.3921、0.3874和0.3498；PSAD（ng/ml/cm3）取0.15、0.25、0.35为临界值时预测前列腺癌的敏感度分别为88.81%、80.60%和73.88%，特异度分别为68.92%、87.84%和95.95%，约登指数分别为0.5733、0.6844和0.6983。结论：在本研究中PSA值分别取10ng/ml、F/T值取0.16、PSAD值取0.35ng/ml/cm3时对前列腺癌的诊断具有较高的敏感度、特异度及约登指数。
[Abstract]:Objective: to evaluate the value of PSAD and PSAD in the diagnosis of prostate cancer.Methods: from July 2005 to August 2012, 208 patients with prostate diseases diagnosed by biopsy and / or operation were selected.They were divided into prostate cancer group (malignant group) and benign prostatic hyperplasia group (benign group), according to the results of transrectal ultrasound, they were divided into nodule group (positive group) and non-nodular group (negative group).The nodules were divided into low echo group and high echo group according to their echo characteristics. The total PSA and free PSAs in serum were measured, and the volume of prostate was measured and PSAD was calculated by F- / T ratio TRUS.Specificity and Yorden index to determine the most appropriate diagnostic criteria for prostate cancer.The sensitivity was 88.81% and 73.88%, the specificity was 68.92% and 95.95%, respectively, and the Yorden index was 0.5733 ~ 0.6844 and 0.6983, respectively.Conclusion: in this study, the sensitivity, specificity and Jordan index of diagnosis of prostate cancer were higher when the PSA value was 10 ng / ml / L F- / T value and 0.16% PSAD value was taken for the diagnosis of prostate cancer.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.25

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