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目的 探讨大体积良性前列腺增生 (BPH)患者高值血清前列腺特异抗原 (PSA)的来源。 方法 对 2 7例术前PSA值 8.1～ 75 .1ng/ml,直肠指诊前列腺≥Ⅲ° ,超声测量前列腺体积 >5 0ml,无前列腺癌 (PCa)迹象的排尿困难患者 ,采用耻骨上前列腺切除术及术后PSA追踪检测方法 ,分析术后PSA值变化的原因以及术前高值PSA的来源。 结果 2 7例切除腺体 4 0～ 1 85g ,平均 82 .7g。病理检查 2例发现PCa灶 ,2 5例未发现PCa灶。术后 1个月内 1例有PCa灶者PSA上升 ,2 6例迅速下降至正常范围。 2 4例获随访 1 7～ 5 7个月 ,PSA 0 .0 8～ 2 .39ng/ml,平均 1 .1 6ng/ml。 结论 大体积BPH患者的高值PSA多源于前列腺移行区增生腺体 ,而非源于外周区
Objective To investigate the origin of high serum PSA (prostate specific antigen) in patients with massive benign prostatic hyperplasia (BPH). Methods Twenty-seven patients with dysuria who had preoperative PSA value of 8.1-75.1ng / ml, digital rectal examination of prostate≥Ⅲ °, ultrasonographic measurement of prostate volume> 50ml and no signs of prostate cancer (PCa) were treated with suprapubic prostatectomy Postoperative PSA tracking and detection methods, analysis of postoperative changes in the value of PSA and the source of high preoperative PSA. Results 27 cases of resected gland 40 ~ 85g, with an average of 82.7g. Pathological examination found 2 cases of PCa stove, 25 cases found no PCa stove. One patient with PCa within 1 month after operation had PSA increased, and 26 patients rapidly dropped to the normal range. Twenty-four patients were followed up for 1-7 months and 57 months, with PSA values of 0.08-2.39ng / ml, with an average of 1.16ng / ml. Conclusion High-value PSA in large-volume BPH patients mostly originate from hyperplastic glands in prostate transitional region, but not from peripheral region