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经直肠前列腺活检后通过总前列腺特异性抗原动态曲线鉴别前列腺癌与良性前列腺疾病

[Differentiation of prostate cancer from benign prostatic disease by total prostate specific antigen dynamic profiles after transrectal prostate biopsy].

作者信息

Shao Qiang, Song Jian, Zhou Zhen-Jun, Du Lin-Dong

机构信息

Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Zhonghua Nan Ke Xue. 2008 Jul;14(7):597-601.

Abstract

OBJECTIVE

To investigate the possibility of differentiating prostate cancer (PCa) from benign prostatic disease by total prostate specific antigen (T-PSA) dynamic profiles following transrectal prostate biopsy, and to determine the cutoff value of the T-PSA ratio between pre- and post-biopsy.

METHODS

A total of 36 men at the mean age of 69.89 years with increased serum PSA underwent prostate biopsy guided by transrectal ultrasound, followed by measurement of T-PSA at 10, 30, 60 and 90 min, plotting of T-PSA dynamic profiles and calculation of the pre- and post-biopsy T-PSA ratio at different time points. The patients were divided into a PCa and a non-PCa group according to the pathological results and compared for the difference in T-PSA ratios. The cutoff value of the pre- and post-biopsy T-PSA ratio was determined for the differentiation of PCa from benign prostatic diseases.

RESULTS

The post-biopsy T-PSA ratio was obviously higher in the non-PCa than in the PCa group (P < 0.05). With the ROC curve applied, the cutoff value of the T-PSA ratio was 1.5 and the best time for blood sampling was 30 minutes after the biopsy, with a 75% sensitivity and a 93% specificity.

CONCLUSION

Evaluation of the T-PSA ratio 30 minutes after biopsy might help screen the high-risk PCa population. Biopsy should be repeated for those with a lower T-PSA ratio in spite of initial benign results. The results are to be further supported by more prospective studies.

摘要

目的

探讨经直肠前列腺穿刺活检后,通过总前列腺特异性抗原(T-PSA)动态曲线鉴别前列腺癌(PCa)与良性前列腺疾病的可能性,并确定穿刺活检前后T-PSA比值的临界值。

方法

对36例平均年龄69.89岁、血清PSA升高的男性患者进行经直肠超声引导下的前列腺穿刺活检,随后在10、30、60和90分钟时测量T-PSA,绘制T-PSA动态曲线,并计算不同时间点穿刺活检前后的T-PSA比值。根据病理结果将患者分为PCa组和非PCa组,比较两组T-PSA比值的差异。确定穿刺活检前后T-PSA比值的临界值,以区分PCa与良性前列腺疾病。

结果

非PCa组穿刺活检后的T-PSA比值明显高于PCa组(P<0.05)。应用ROC曲线,T-PSA比值的临界值为1.5,最佳采血时间为活检后30分钟,灵敏度为75%,特异度为93%。

结论

活检后30分钟评估T-PSA比值可能有助于筛查高危PCa人群。对于T-PSA比值较低的患者,尽管初始结果为良性,也应重复活检。本研究结果有待更多前瞻性研究进一步证实。

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