前列腺炎患者治疗前后PSA变化及其临床意义

黄宝星; 宿恒川; 曹万里; 孙福康

前列腺炎患者治疗前后PSA变化及其临床意义

- 上海交通大学医学院附属瑞金医院泌尿外科(上海, 200025)

详细信息

通讯作者: 孙福康,E-mail:sunfukang6@126.com

中图分类号: R697.33

收稿日期: 2012-07-24

Clinical significance of the changes in serum PSA before and after the treatment for patients with prostatitis

- Department of Urology, Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College, Shanghai, 200025, China

More Information

Corresponding author: SUN Fukang, E-mail: sunfukang6@126.com

Received Date: 24 July 2012

摘要

摘要: 目的：探讨伴有PSA升高的ⅢA型前列腺炎患者药物治疗后血清PSA的变化，评估PSA变化率对疗效的预测价值。方法：收集2010年9月~2012年3月期间门诊就诊的有4 μg/L结果：穿刺活检患者共60例，其中12例证实为PCa，43例为慢性前列腺炎，5例为BPH。前列腺炎患者治疗前后PSA相关指标（PSA，游离/总PSA，PSA密度）和CPSI评分均出现显著变化，各指标差异均有统计学意义（P<0.05）；PSA变化率（PSA-VCh）对鉴别诊断PCa有一定价值，在最佳临界点-5.22%处，敏感度和特异度分别为84.7%和78.6%；治疗后前列腺炎症分级与PSAD及CPSI间存在相关性（r=0.518，r=0.379，P均<0.05），PSA-VCh与ΔCPSI及患者治疗前PSA均呈中等相关（r=0.481，r=0.410，P均<0.01﹚。结论：抗感染治疗后，可使伴有PSA升高的ⅢA型前列腺炎患者主客观指标均得以改善；PSA变化率可作为评估慢性前列腺炎治疗效果的有价值指标，并为排除PCa提供依据。
- ⅢA型前列腺炎 /
- 前列腺特异性抗原变化率 /
- 前列腺活检 /
- 慢性前列腺炎症状指数评分
Abstract: Objective: To study the variations in serum PSA after the treatment for ⅢA prostatitis with elevated PSA levels, and to evaluate the clinical significance of PSA value change rate in prediction of efficacy.Method: The study included 60 suspected type ⅢA prostatitis patients from September 2010 to March 2012 with their PSA level ranged from 4 μg/L to 50 μg/L. All the patients underwent antibacterial therapy for 4 weeks. PSA levels and the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) were studied before and after the treatment. We summarized and studied the related data.Result: The biopsies of 60 patients revealed prostate cancer (PCa) in 12 patients, chronic prostatitis (CP) in 43 patients and benign prostatic hyperplasia (BPH) in five patients. The related indexes of PSA(PSA, f/tPSA, PSAD)and NIH-CPSI scores demonstrated significant differences before and after treatment (P<0.05). PSA value change (PSA-VCh) had certain significance in the diagnosis of prostate cancer, and the cut-off point was -5.22% with sensitivity and specificity of 84.7% and 78.6%. The grade of inflammation correlated positively with PSAD (r=0.518, P=0.01) and CPSI score (r=0.379, P=0.012) after treatment. PSA-VCh manifested moderately positive correlations with ΔCPSI (r=0.481, P=0.001) and the initial PSA levels (r=0.410, P=0.006).Conclusion: After using antibacterial therapy for 4 weeks, significant improvement of subjective and objective indicators were achieved in ⅢA prostatitis with elevated PSA levels. PSA-VCh can be regarded as a valuable indicator in predication of efficacy for the treatment of chronic prostatitis, and provide basis for the differential diagnosis of PCa.
- type ⅢA prostatitis /
- prostatic-specific antigen value change /
- prostate biopsy /
- National Institutes of Health Chronic Prostatitis Symptom Index

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参考文献(13)

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