血清 PSA 升高患者行与不行抗生素治疗时前列腺穿刺活检结果与 PSA 和游离 PSA 比值变化的关系。

The Relationship Between Prostate Biopsy Results and PSA and Free PSA Ratio Changes in Elevated Serum PSA Patients with and without Antibiotherapy.

机构信息

Samsun Training and Research Hospital, Department of Urology, Samsun, Turkey.

Department of Urology, Baskent University School of Medicine, Ankara, Turkey.

出版信息

Asian Pac J Cancer Prev. 2020 Apr 1;21(4):1051-1056. doi: 10.31557/APJCP.2020.21.4.1051.

DOI:10.31557/APJCP.2020.21.4.1051

PMID:32334469

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7445968/

Abstract

OBJECTIVES

To evaluate the impact of antibiotic treatment on total prostate specific antigen (PSA) levels and free/total (f/t) PSA ratio and the relevance of these changes to prostate biopsy results.

METHODS

We retrospectively evaluated 1,062 patients with elevated age-adjusted serum PSA levels who underwent prostate biopsy between 2004 and 2016. A total of 303 cases with followup PSA levels and f/t PSA ratio before and after antibiotherapy were included into this study. There were 214 patients with persistent elevated serum PSA levels after antibiotic treatment followed by prostate biopsy (treatment group) and 89 patients who had prostate biopsy after a mean followup of 1 month without antibiotherapy (control group). The groups were compared with regard to both 5% and 10% cut off changes in serum PSA levels and f/t PSA ratios.

RESULTS

Antibiotic treatment had no impact on the relation between serum PSA levels and biopsy results at both cut off values. On the other hand, f/t PSA ratio changes at both cut off values with relevance to antibiotic treatment were found to be related with histopathologic results. While increase in f/t PSA ratio was more related with benign biopsies, decrease in f/t PSA ratio was more related with cancer (for 5% cut off value p= 0.014, p= 0.004; for 10% cut off value p= 0.026, p= 0.014).

CONCLUSION

Changes at f/t PSA ratio rather than total PSA only, particularly in antibiotic treated cases appear to be more useful in decision making for biopsy.

摘要

目的

评估抗生素治疗对总前列腺特异性抗原（PSA）水平和游离/总（f/t）PSA 比值的影响，以及这些变化与前列腺活检结果的相关性。

方法

我们回顾性评估了 2004 年至 2016 年间因年龄调整后血清 PSA 水平升高而接受前列腺活检的 1062 例患者。共纳入 303 例有随访 PSA 水平和 f/t PSA 比值的患者，这些患者在接受抗生素治疗前后进行了前列腺活检。其中 214 例患者在抗生素治疗后持续出现血清 PSA 水平升高，随后进行了前列腺活检（治疗组），89 例患者在没有接受抗生素治疗的情况下平均随访 1 个月后进行了前列腺活检（对照组）。比较两组患者在血清 PSA 水平和 f/t PSA 比值的 5%和 10%截点变化方面的差异。

结果

抗生素治疗对血清 PSA 水平与活检结果之间的关系没有影响。另一方面，在这两个截定点上，f/t PSA 比值的变化与抗生素治疗相关，与组织病理学结果相关。当 f/t PSA 比值增加时，更与良性活检相关，而当 f/t PSA 比值降低时，更与癌症相关（对于 5%截定点，p=0.014，p=0.004；对于 10%截定点，p=0.026，p=0.014）。