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目的分析前列腺癌患者血清中前列腺特异性抗原(PSA)水平、游离前列腺特异抗原与总前列腺特异抗原的比值(f-PSA/t-PSA)与Gleason评分的相关性,探讨血清PSA水平在前列腺癌诊断和鉴别中的临床应用价值。方法回顾性分析2014年6月—2015年9月在绍兴市人民医院泌尿外科治疗的109例前列腺癌患者的临床资料,所有患者均在B超引导下经直肠前列腺活检确诊为前列腺癌,根据患者的临床资料统计有无家族遗传史,并依据癌症TNM分类标准统计患者的临床分期,统计不同分类患者血清PSA平均水平,评价患者血清PSA、f-PSA/t-PSA水平与前列腺病理组织的Gleason评分的相关性。结果有家族患病史患者的平均血清PSA水平为(323.59±267.15)ng/ml,远高于没有家族史的患者(198.11±100.22)ng/ml,P<0.05;不同TNM临床分期患者的血清PSA水平差异较大,Ⅰ期患者的血清PSA水平最低,平均为(6.28±4.08)ng/ml,Ⅳ期最高,为(459.08±123.01)ng/ml;前列腺癌患者血清PSA水平与前列腺组织病理切片的Gleason评分呈正相关(r=0.367,P<0.001)。低分化癌患者的平均血清f-PSA/t-PSA为0.145±0.017,中分化癌患者为0.225±0.021,高分化癌患者为0.345±0.104,前列腺癌病理组织的Gleason评分与血清f-PSA/t-PSA成负相关(r=-0.378,P=0.008)。结论血清前列腺素特异抗原与前列腺组织Gleason评分具有相关性,对前列腺癌的早期临床诊断和治疗有重要意义,应列入前列腺癌的筛查方案。
Objective To analyze the correlation between the serum PSA level and the ratio of free prostate specific antigen to total prostate specific antigen (f-PSA / t-PSA) and Gleason score in patients with prostate cancer and to explore the relationship between serum PSA level and prostate cancer Diagnostic and differential clinical value. Methods The clinical data of 109 patients with prostate cancer undergoing urology from Shaoxing People’s Hospital from June 2014 to September 2015 were retrospectively analyzed. All patients were diagnosed as prostate cancer by transrectal prostate biopsy under B-ultrasound. According to the patients According to the TNM classification of cancer, the clinical staging of patients was calculated. The average level of serum PSA in different categories of patients was statistically analyzed. The levels of serum PSA, f-PSA / t-PSA and the level of Gleason Relevance of the score. Results The average serum PSA level of patients with familial history was (323.59 ± 267.15) ng / ml, much higher than those without family history (198.11 ± 100.22) ng / ml, P <0.05. Serum PSA levels were significantly different in patients with stage Ⅰ disease, with the lowest level of serum PSA in stage Ⅰ patients (mean, 6.28 ± 4.08 ng / ml, the highest in stage Ⅳ, (459.08 ± 123.01) ng / ml); PSA levels in prostate cancer patients were significantly different from those in benign prostatic tissues The Gleason score was positively correlated (r = 0.367, P <0.001). The average serum f-PSA / t-PSA was 0.145 ± 0.017 in patients with poorly differentiated cancer, 0.225 ± 0.021 in patients with moderately differentiated cancer, and 0.345 ± 0.104 in patients with well-differentiated cancer. The Gleason score of the pathological tissue of the patients with poorly differentiated cancer was significantly lower than that of the serum f-PSA / T-PSA was negatively correlated (r = -0.378, P = 0.008). Conclusions Serum prostaglandin-specific antigen is associated with Gleason score of prostate tissue, which is of great significance for the early clinical diagnosis and treatment of prostate cancer. It should be included in the screening program of prostate cancer.