PSA相关标志物及前列腺穿刺针数的研究在前列腺癌诊断中的价值

发布时间：2018-05-09 04:06

本文选题：前列腺癌 + 前列腺穿刺活检术　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨在PSA灰区(tPSA 4~10ng/ml)患者中,f/tPSA、PSAD和(f/t)PSA/PSAD值,以及增加穿刺针数和位点在前列腺癌诊断中的临床价值。方法:回顾2008年1月至2016年3月我院接受TURS引导下前列腺穿刺的患者929例,对其中249例tPSA 4~10ng/ml患者的临床资料进行了整理分析。根据病理回报结果,分为前列腺癌组(PCa组)38例(15.26%),前列腺增生组(BPH组)211例(84.74%)。对患者年龄、tPSA、f/tPSA、PV、PSAD、(f/t)PSA/PSAD值做统计学分析。根据患者前列腺的穿刺针数和位点分组:A组,穿刺13针,共有病例218例;B组,穿刺13+n针,共有病例31例。比较两组患者在不同穿刺针数下的穿刺阳性率差异有无统计学意义。结果:根据患者前列腺穿刺的针数和位点分组,A组218例中病理报告为癌的有27例,穿刺阳性率12.39%;B组31例中病理报告为癌的有11例,穿刺阳性率35.48%。根据χ~2检验,增加穿刺针数和位点后阳性率增加有统计学意义(χ~2=9.48,P0.005)。两组患者在年龄水平差异无统计学意义(P0.05);在f/tPSA、PV、(f/t)PSA/PSAD水平,BPH组大于PCa组;在tPSA、PSAD水平,PCa组大于BPH组,差异均有统计学意义(P0.05)。PCa组中f/tPSA或PSAD异常者32例,占84.21%;BPH组中f/tPSA或PSAD异常者110例,占52.13%,差异有统计学意义(χ~2=13.52,P0.005)。结论:对于PSA灰区(tPSA 4~10ng/ml)的患者,可能为早期患者肿瘤病灶较小,要果断增加穿刺针数和位点,以提高穿刺阳性率。f/t PSA和PSAD异常对PSA灰区的患者是否行前列腺穿刺具有指导意义。如果f/t PSA和PSAD结果相矛盾,f/tPSA联合PSAD、PSAD联合(f/t)PSA/PSAD的诊断价值相对较高。
[Abstract]:Objective: to investigate the clinical value of fr / tPSAD and PSAD / PSAD in patients with 10 ng / ml TPSA in PSA gray region, and to evaluate the clinical value of increasing the number and locus of puncture needles in the diagnosis of prostate cancer. Methods: from January 2008 to March 2016, 929 cases of prostate puncture guided by TURS in our hospital were reviewed and the clinical data of 249 cases with tPSA 4~10ng/ml were analyzed. According to the pathological results, 38 cases were divided into PCA group (n = 38), BPH group (n = 211) and BPH group (n = 211). The age of patients with PSAD was analyzed statistically. According to the number and site of puncture needle of prostate, the patients were divided into two groups: group 1: group A: 13 needles, group B 218 cases, needle puncture 13 n, total cases 31 cases. To compare the positive rate of puncture between the two groups under different number of puncture needles. Results: according to the needle number and the site of prostate puncture, 27 cases of 218 cases in group A were pathologically reported as cancer, 11 cases of 31 cases in group B were diagnosed as cancer, and the positive rate of puncture was 35.48%. According to 蠂 ~ 2 test, there was statistical significance in increasing the number of puncture needles and the positive rate after the locus (蠂 ~ 2 + 9.48) (P 0.005). There was no significant difference in age level between the two groups (P 0.05); there was no significant difference between the two groups in age level (P 0.05); in the f / t PSAD group, the level of f/tPSA or PSAD was higher in BPH group than in PCa group; in BPH group, there were 32 cases of abnormal f/tPSA or PSAD in BPH group, accounting for 110 cases of f/tPSA or PSAD abnormality in 84.21 BPH group. The difference was statistically significant (蠂 2 + 13.52% P 0.005). Conclusion: for the patients with PSA gray area, it may be that the tumor focus is small in the early stage patients. It is necessary to increase the number of puncture needles and the number of puncture points so as to increase the positive rate of puncture. F- / t PSA and PSAD abnormality may be helpful for the patients with PSA gray area to perform prostate puncture or not. If the results of frt PSA and PSAD are inconsistent, the diagnostic value of frtPSA combined with PSAD combined with frtr / TSA / PSAD is relatively high.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.25

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