前列腺癌诊断方法临床应用.docVIP

前列腺癌诊断方法临床应用 　【摘要】 目的 探讨前列腺癌诊断方法的价值及其与临床分期、病理分级的关系。 方法 对36例经病理检查证实的前列腺癌患者以及81例前列腺增生患者的临床资料进行分析，比较两组患者的年龄、PSA及PSAD水平有无差别，对36例前列腺癌患者所用的诊断方法进行评价，并分析PSA与前列腺癌临床分期和病理分级的关系。结果 前列腺癌患者和前列腺增生患者的年龄无差别，两组的PSA值和PSAD 值有差别，把PSA阈值定为4ng／ml时，诊断前列腺癌的灵敏度89.29％，特异度为59．26％，阳性预测值为43.10％。把PSAD阈值定为0．15时，灵敏度为8l.82％，特异度为80．85％，阳性预测值为66．67％。 A、B期和C、D期前列腺癌患者的PSA值无差别，Gleason评分2～6分和7～10分患者的PSA值无差别。结论 前列腺癌和前列腺增生的发病年龄基本相同，PSA和PSAD诊断前列腺癌均有一定的价值，PSAD的诊断价值可能更大，用PSA值判断前列腺癌临床分期和病理分级的作用可能不大。 【关键词】 前列腺癌； 诊断方法； 评价 【Abstract】 Objective To evaluate diagnostic methods in patients with prostatic carcinoma and relationship between serum levels of PSA and clinical stages，pathological grades． Methods Both 36 patients with prostatic cacinoma and 81 patients with BPH were determined by pathological examination．Age，PSA levels and PSAD levels in patients with prostatic cacinoma were compared with which in patients with BPH． The relationship between PSA levels and clinica1 stages，pathological grades in patients with prostatic carcinoma were evaluated．Results There was no difference between age in patients with prostatic carcinoma and age in patients with BPH．PSA and PSAD levels were difference between patients with prostatic carcinoma and patients with BPH．When PSA level was of 4ng／ml or greater，the sensitivity of PSA as a method to detect prostatic carcinoma was 89.29％，the specificity was 59.26％ and the positive predictive value was 43.10％．When PSAD level was of 0.15 or greater, the sensitivity of PSAD as a method to detect prostatic carcinoma was 81．82％，the specificity was 80.85％ and the positive predictive value was 66.67% PSA level was no difference between A to B stage and C to D stage：PSA level was no difference between Gleason scores less then 7 and Gleason scores 7 or greater．Conclusion Age in patients with prostatic carcinoma and patients with BPH was similarly．Both PSA and PSAD had good values to detect prostatic carcinoma and PSAD might be better．PSA as a predictor of prognosis could not be confirmed． 【K