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目的分析前列腺特异性抗原(PSA)灰区(4～10 ng/ml)与前列腺癌的关系,探索如何提高灰区PSA水平的前列腺癌活检诊断率。方法对2004年3月至2005年3月间,PSA介于灰区、接受前列腺穿刺活检的72例病人资料进行回顾分析。包括肛指检查、IPSS评分、经直肠超声(TRUS)检查、PSA密度(PSAD)、游离/总PSA(F/T)比值以及病理学酶标检查。结果穿刺组织病理学检查证实为前列腺癌14例(19.2%),平均年龄(74.2±2.4)岁,IPSS(12.9±4.5),PSAD(0.29±0.04),F/T(0.11±0.02)。GS评分≤6共9例,GS=7共2例,GS≥8共3例。肛指有结节3例,无结节11例。TRUS低回声区2例,等回声区2例,回声不均6例,回声均匀4例。前列腺尖部穿刺阳性率占51.4%。结论PSAD和F/T在PSA灰区的前列腺癌和前列腺增生两组间有明显差别;PSA灰区范围内,前列腺尖部是前列腺癌的高发部位。
Objective To analyze the relationship between prostate specific antigen (PSA) gray zone (4 ~ 10 ng / ml) and prostate cancer and explore how to improve the diagnostic rate of prostate cancer biopsy with gray zone PSA. Methods Between March 2004 and March 2005, the data of 72 patients with PSA in the gray area undergoing prostate biopsy were retrospectively analyzed. Including the anal finger examination, IPSS score, transrectal ultrasound (TRUS) examination, PSA density (PSAD), free / total PSA (F / T) ratio and pathological examination. Results The results of biopsy showed that prostate cancer was found in 14 cases (19.2%) with mean age (74.2 ± 2.4) years, IPSS (12.9 ± 4.5), PSAD (0.29 ± 0.04) and F / T (0.11 ± 0.02). GS score ≤ 6 in 9 cases, GS = 7 in 2 cases, GS ≥ 8 in 3 cases. Anal nodules in 3 cases, nodules in 11 cases. TRUS hypoechoic area in 2 cases, such as echo in 2 cases, 6 cases of unequal echo, echo in 4 cases. Prostate puncture-positive rate accounted for 51.4%. Conclusions PSAD and F / T are significantly different between the two groups of prostate cancer and benign prostatic hyperplasia in the PSA gray zone. Within the scope of the gray zone of PSA, the tip of the prostate is a high incidence of prostate cancer.