摘要
目的探讨抗炎治疗后亚临床型前列腺炎患者血清PSA变化及其临床意义。方法直肠指检阴性的亚临床型前列腺炎患者136例。实验室检查PSA 4．2～49．7（14．0±7．8）ng／ml。136例予抗炎治疗后2周复查PSA并在B超引导下行前列腺穿刺活检。评估抗炎治疗前后PSA、PSA密度（PSAD）、游离／结合PSA（f／tPSA）及其变化（△PSA、△PSAD、△f／t PSA），受试者工作特征（ROC）曲线分析抗炎前后各参数对前列腺癌的诊断效力。采用SPSS11．0软件对组间行t检验。结果136例穿刺活检诊断为前列腺癌33例，良性病变103例。抗炎治疗前后相比：PSA由（14．0±7．8）ng／ml降至（10．4±7．7）ng／ml、PSAD从（0．24±0．12）ng·ml^-1·ml^-1降至（0．18±0．12）ng·ml^-1·ml^-1、f／tPSA从0．23±0．08降至0．16±0．07，治疗前后比较差异均有统计学意义（P〈0．05）。△PSA、△PSAD和△f／tPSA分别为（-3．59±4．34）ng／ml、（-0．10±0．09）ng·ml^-1·ml^-1及-0．06±0．05。抗炎治疗前PSA、PSAD和f／tPSA诊断前列腺癌ROC曲线下面积分别为0．288、0．642和0．504，△PSA、△PSAD和△f／tPSA诊断前列腺癌ROC曲线下面积分别为0．910、0．957和0．983，与治疗前比较差异均有统计学意义（P值均〈0．01）。结论亚临床型前列腺炎伴有PSA增高者经抗炎治疗2周后血清PSA明显下降；利用抗炎治疗后△PSA、△PSAD、△f／tPSA可提高前列腺癌的诊断率，减少不必要的前列腺穿刺活检。
Objective To evaluate the clinical significance of PSA changes in asymptomatic prostatitis patients after antibacterial treatment. Methods A cohort of 136 asymptomatic prostatitis patients with mean PSA 14.0-7.8 ng/ml （range 4.2-49.7 ng/ml） and normal digital rectal examination findings were included. All these patients underwent antibacterial therapy for 2 weeks before they had repeated PSA tests and transrectabultrasound guided prostate biopsies. The changes of PSA, PSA density（PSAD） and free/total PSA ratio（f/t PSA） were assessed. The effectiveness of PSA, PSAD and f/t PSA ratio after antibacterial treatment and their changes （△PSA, △f/t PSA, △PSAD） on prostate cancer detection were analyzed using the receiver operating characteristics （ROC） technique. Data were analyzed by SPSS 11.0 software. Results Of the 136 patients accepting prostate biopsies, 33 patients were diagnosed with prostate cancer and the other 103 patients were histologically confirmed with benign prostatic disease. After 2 weeks antibacterial treatment, the PSA level dropped from 14.0±7.8 ng/ml to 10.4±7.7 ng/ml （P〈0.01） ; The PSAD changed from 0.24 ± 0.12 ng/ml/ml to 0.18 ± 0.12 ng/ml/ml （P〈0.05） and f/t PSA ratio changed from 0. 23±0. 08 to 0.16±0.07（P〈0.05）; The △PSA, △PSAD and △f/tPSA were --3. 59±4.34 ng/ml, --0. 10± 0.09 ng/ml/ml and --0.06±0.05, respectively. The areas under ROC curve of △PSA, △, △f/t PSA, which improved the efficiency of prostate cancer detection significantly when compared with those parameters before antibacterial treatment, were 0. 910, 0. 957 and 0. 983, respectively （all the P values（0.01）. Conclusions The PSA value changes significantly after 2 weeks antibacterial treatment for asymptomatic prostatitis patients with PSA≥4 ng/ml. By using the parameters after antibacterial treatment, △PSA, △PSAD and △f/t PSA can improve the prostate cancer detection rate and decrease the unnecessary prostate biopsy.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2009年第11期780-783,共4页
Chinese Journal of Urology
基金
广东省卫生厅科学技术基金资助项目（A2008522）
广州市卫生局资助项目（2007-YB-014）
关键词
前列腺炎
前列腺特异抗原
抗菌药
前列腺肿瘤
Prostatitis
Prostate-specific antigen
Anti-bacterial agents
Prostatic neoplasms
