前列腺健康指数在不同tPSA区间段诊断前列腺癌的临床价值研究-现代医学

前列腺健康指数在不同tPSA区间段诊断前列腺癌的临床价值研究

单位：苏北人民医院建湖分院泌尿外科, 江苏建湖 224700

分类号：R446.11; R737.25

出版年·卷·期（页码）：2023·51·第七期（918-922）

摘要：

目的: 分析前列腺健康指数(PHi)在不同总前列腺特异抗原(tPSA)区间段诊断前列腺癌的临床价值。方法: 选定本院2019年1月至2022年1月住院治疗且tPSA>4 ng·ml^-1的110例前列腺癌患者作为观察组,以及同期tPSA>4 ng·ml^-1的110例前列腺增生(BPH)患者作为参照组,均进行前列腺特异性抗原同源异构体2(p2PSA)、游离前列腺特异性抗原(fPSA)、tPSA检测,计算PHi值,比较不同tPSA区间和Gleason分组中p2PSA、fPSA、tPSA、PHi,并评价p2PSA、fPSA、tPSA、PHi对前列腺癌的诊断效能。结果: 观察组p2PSA、tPSA、fPSA、PHi均高于参照组(P<0.05)。Gleason评分 ≥ 7分组p2PSA、tPSA、PHi高于Gleason ≤ 6分组(P<0.05)。在tPSA灰区(4 ng·ml^-1 < tPSA ≤ 10 ng·ml^-1)中,观察组的PHi显著高于参照组(P<0.05),而在其他分区中差异不显著。同时在此区间中,PHi的ROC曲线下面积(AUC)、特异度、灵敏度、阳性预测值、阴性预测值均高于p2PSA和fPSA(P<0.05)。结论: PHi在4 ng·ml^-1 < tPSA ≤ 10 ng·ml^-1区间的前列腺癌中具有较高的诊断效能,临床可作为tPSA灰区中诊断前列腺癌的重要指标。

Objective: To analyze the clinical value of prostate health index (PHi) in the diagnosis of prostate cancer at different intervals of total prostate specific antigen (tPSA). Methods: 110 patients with prostate cancer (tPSA > 4 ng·ml^-1) hospitalized in our center from January 2019 to January 2022 were included as the observation group, and 110 patients with benign prostatic hyperplasia (tPSA > 4 ng·ml^-1) in the same period were included as the reference group. p2PSA, fPSA and tPSA were detected, and the PHi values were calculated based on them. p2PSA, fPSA, tPSA and PHi in different tPSA intervals and Gleason groups were compared to evaluate their diagnostic efficiency. Results: p2PSA, tPSA, fPSA and PHi in the observation group were all higher than those in the reference group (P<0.05). p2PSA, tPSA and PHi in Gleason score ≥ 7 group were all higher than those in ≤ 6 group (P<0.05). In the tPSA gray zone (4 ng·ml^-1 < tPSA ≤ 10 ng·ml^-1), the PHi of the observation group was significantly higher than that of the reference group (P<0.05), but there was no significant difference in other tPSA intervals. At the same time, Area Under Curve (AUC) of receiver operating characteristic curve, specificity, sensitivity, positive predictive value and negative predictive value of PHi were higher than those of p2PSA and fPSA in this interval (4 ng·ml^-1 < tPSA ≤ 10 ng·ml^-1, P<0.05). Conclusion: PHi has high diagnostic efficiency in prostate cancer in the range of 4 ng·ml^-1 < tPSA ≤ 10 ng·ml^-1 and can be used as an important index to diagnose prostate cancer in the gray zone of tPSA.

参考文献：

[1] DENIS-BACELAR A M, CHITTENDEN S J, DEARNALEY D P, et al. Phase Ⅰ/Ⅱ trials of 186Re-HEDP in metastatic castration-resistant prostate cancer:post-hoc analysis of the impact of administered activity and dosimetry on survival[J].Eur J Nucl Med Mol I,2017, 44(4):620-629.
[2] 余杰,王旸,贾彦召,等.适形调强放疗联合内分泌治疗对局部晚期前列腺癌患者血清肿瘤学指标与无转移生存率的影响[J].现代泌尿外科杂志,2018,23(8):609-612,630.
[3] 孙奎霞,闫存玲,李志艳,等.前列腺特异性抗原同源异构体2及其衍生指标在预测前列腺癌病理分级中的价值[J].北京大学学报(医学版),2020,52(2):234-239.
[4] 中华放射学杂志前列腺疾病诊疗工作组,中华放射学杂志编辑委员会.前列腺癌MRI检查和诊断共识(第二版)[J].中华放射学杂志,2018,52(10):743-750.
[5] 中国中西医结合学会男科专业委员会.良性前列腺增生中西医结合诊疗指南(试行版)[J].中华男科学杂志,2017,23(3):280-285.
[6] 张帆,左强,黄毅,等.核磁共振与超声融合成像引导下前列腺靶向穿刺对Gleason评分 ≥ 7分前列腺癌检出的临床意义[J].中国男科学杂志,2018,32(3):33-36,46.
[7] 沈志远,陶晶,徐骏,等.转移性去势抵抗性前列腺癌多西他赛/泼尼松治疗失败后加用雌二醇氮芥的疗效和安全性:单中心回顾性研究[J].临床泌尿外科杂志,2020,35(3):180-183.
[8] 宋文斌.LRP手术对前列腺癌患者的治疗效果及对患者血清miR-146a、PSA、PSMA水平的影响[J].解放军预防医学杂志,2018,36(8):1029-1031,1056.
[9] 蒋炳辰,张雪辉,孔飚,等.SPECT/CT融合骨显像、前列腺血清学指标和骨代谢指标对前列腺癌骨转移的诊断价值[J].广西医学,2020,42(1):17-20,32.
[10] TOMASZEWSKI M R, QUIROS G I, JAMES P O, et al. Oxygen enhanced optoacoustic tomography(OE-OT)reveals vascular dynamics in murine models of prostate cancer[J]. Theranostics,2017,7(11):2900-2913.
[11] 李林,阎成全,翟玉普,等.游离前列腺特异性抗原与总前列腺特异性抗原比值在不同总前列腺特异性抗原水平时对提高前列腺癌检出率的价值[J].中国煤炭工业医学杂志,2017,20(12):1425-1429.
[12] 吴凌梅,王庆云,杨晖,等.18F-FDG PET/CT影像检查与前列腺癌骨转移患者tPSA、fPSA、ALP表达水平的相关性[J].中华生物医学工程杂志,2019,25(5):631-636.
[13] 王志粉,王书中,杨士军,等.探讨血清tPSA、fPSA及其比值在淮安地区进行前列腺疾病筛查以及前列腺癌鉴别的合理运用[J].标记免疫分析与临床,2018,25(3):329-332.
[14] 曹志彬,夏琴琴,张华英,等.前列腺健康指数对前列腺特异性抗原处于灰区前列腺癌的诊断价值[J].临床和实验医学杂志,2020,19(16):1741-1744.

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