摘要
目的研究高分级前列腺上皮内瘤（high grade prostatic introepithelial neoplasia，HGPIN）预测前列腺癌的临床价值。方法对243例经过前列腺特异性抗原、直肠指诊和经直肠超声（transrectal ultrasounds，TRus）检查出现异常的可疑前列腺癌患者行间隔1年为期2年的TRUS引导下的前列腺穿刺或经尿道前列腺电切，行组织活检及重复活检，对结果中存在HGPIN的实验组与无HGPIN的对照组进行分析研究。结果243例患者中失访2例，平均随访36个月。首次活检结果前列腺癌23例，其中伴HGPIN16例（69．6％）；HGPIN51例。第1次重复活检63例，诊断前列腺癌19例，其中伴HGPIN13例（68．4％），新发现HGPIN12例。第2次重复活检43例，前列腺癌11例，伴HGPIN7例（63．6％）；新发现HGPIN5例。实验组68例，对照组150例。前列腺癌伴HGPIN的发生率（67．9％）明显高于非前列腺癌患者（25．0％）（P〈0.05）。2组重复活检前列腺癌的检出率（实验组30．9％，对照组6．0％，P〈0.05）及2年无瘤生存率Log-Rank检验（P〈0.05）差异均有统计学意义。HGPIN诊断前列腺癌的敏感度和特异度的ROC检验P〈0．01，COX比例风险模型分析显示HGPIN是前列腺癌发生的危险因素。结论HGPIN与前列腺癌的发生有关，对诊断前列腺癌有预测价值。
Objective To study the clinical value of high grade prostatic intraepithelial neoplasia （HGPIN） for predicting prostate cancer. Methods Two hundred and forty-three patients with sus- picious prostate cancer by elevation of prostatic specific antigen （PSA）, abnormal digital rectal examination （DRE） and transrectal ultrasounds （TRUS）, in which the biopsies and re-biopsies were performed by transrectal needle or transurethral resection of prostate, were followed up for 2 years. The results of biopsies were analyzed statistically between the group with HGPIN and the group without. Results Of 243 cases, 241 received an average of 36 months follow-up （ranged 23 to 42 months）, in which 23 cases of prostate cancer were diagnosed on the first biopsy, HGPIN in 16 （69.6%）, and 51 showed HGPIN only. The first re-biopsy was done in 63 patients, with 19 diagnosed with prostate cancer, 13 accompanied by HGPIN （68.4%）, and with new diagnosed HGPIN in 12. The second rebiopsy was done in 43 patients, 11 patients were diagnosed with prostate cancer, 7 accompanied by HGPIN （63.6%）, and 5 showed new discovered HGPIN. Of 243 cases, 68 entered into the trial and 150 into the control. There was a significance in the incidence of HGPIN with prostate cancer （67.9%） compared to without（25.0%） （P〈0.05）, and it also showed a statistical significance in the incidence of prostate cancer on re-biopsy in which the trial and the control were 30.9%, 6.0%, respectively. The 2 years free-tumor survival was significant different between 2 groups（P〈0.05）. The ROC test of sensitivity and specificity for HGPIN predicting cancer showed P〈0.01, and HGPIN tes tified by COX ratio hazard model was a risk factor to diagnose prostate cancer. Conclusions HGPIN is related to the occurrence of prostate cancer, and it shows the predicting value to diagnose prostate cancer.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2007年第9期623-626,共4页
Chinese Journal of Urology
关键词
前列腺肿瘤
重复活检
前列腺上皮内瘤
Prostatic neoplasms
Re-biopsy
Prostatic intraepithelial neoplasia
