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目的综合利用PSA及其相关参数建立能够简便查询的前列腺穿刺阳性率查询表。方法纳入2009年7月至2015年3月在解放军总医院行前列腺穿刺活检的患者,收集前列腺体积、游离PSA(free PSA,fPSA)和总PSA(total PSA,tPSA)等临床资料。多因素Logistic回归分析预测前列腺癌的独立性影响因素,并利用相关因素建立前列腺穿刺阳性结果查询表。结果资料完整且病理结果为前列腺癌和前列腺增生的患者纳入研究,共1 077例。根据PSA水平分为0~2.5、2.6~4.0、4.1~10.0、10.1~20.0和>20.0ng/ml 5组,前列腺癌检出率分别为20.9%、20.0%、37.3%、48.1%和80.2%,随着PSA水平的升高,前列腺癌检出率也明显升高。多因素Logistic回归分析发现tPSA、fPSA和前列腺体积均为前列腺癌的独立性预测因素,tPSA、fPSA百分比(free to total PSA,f/tPSA)和PSA密度(PSA density,PSAD)在前列腺癌和前列腺增生两组间存在显著差异(P<0.05),综合利用上述3个指标建立前列腺阳性穿刺查询表。结论本研究根据tPSA、f/tPSA和PSAD建立的查询表为临床前列腺穿刺活检提供了一个简便实用的阳性率查询工具。
Objective To comprehensively use PSA and its related parameters to establish a prospective prostate biopsy questionnaire. Methods The clinical data of prostate volume, free PSA (fPSA) and total PSA (total PSA, tPSA) were collected from patients undergoing prostate biopsy from July 2009 to March 2015 in PLA General Hospital. Multivariate Logistic regression analysis predicts the factors that influence the independence of prostate cancer and establishes the questionnaire about positive results of prostate biopsy by using relevant factors. Results The data were complete and the pathological results of prostate cancer and benign prostatic hyperplasia were included in the study, a total of 1 077 cases. The detection rates of prostate cancer were 20.9%, 20.0%, 37.3%, 48.1% and 80.2% respectively according to the level of PSA in 0 ~ 2.5,2.6 ~ 4.0,4.1 ~ 10.0,10.1 ~ 20.0 and> 20.0ng / , With the PSA level increased, the detection rate of prostate cancer also increased significantly. Multivariate logistic regression analysis showed that both tPSA, fPSA, and prostate volume were independent predictors of prostate cancer, and tPSA, free to total PSA (f / tPSA), and PSA density (PSAAD) were significantly higher in prostate cancer and prostate Proliferation of two groups were significantly different (P <0.05), the comprehensive utilization of the above three indicators to establish a positive prostate puncture query form. Conclusions This study provides a simple and practical tool for searching the positive rate of clinical prostate biopsies based on the questionnaires established by tPSA, f / tPSA and PSAD.