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目的:评价前列腺体积调整的PSA衍生物在诊断前列腺癌中的价值,以减少不必要的前列腺穿刺检查。方法:选取2014年1月1日~2015年10月31日在我院行经会阴10针前列腺穿刺的374例患者,收集所有患者的年龄、PSA、前列腺总体积、前列腺内腺体积、前列腺经直肠超声检查结果等指标,并通过计算得出PSA密度(PSAD)、外腺PSA密度(PZPSAD)以及内腺PSA密度(TZPSAD)。根据PSA指标或经直肠超声结果将患者分为多个亚组进行比较。对穿刺标本进行病理学检查,以确定前列腺癌的诊断和分级。结果:在所有374例患者中,164例(43.9%)被诊断为前列腺癌,其中136例(36.4%)的PSA≤10μg/L,154例(41.2%)在经直肠超声中发现可疑结节。在各个亚组中,TZPSAD在诊断前列腺癌的能力上均高于PSAD和PZPSAD,并且随着前列腺癌分级的提高,TZPSAD也随之提高。结论:在临床前列腺穿刺活检的决策过程中,TZPSAD可以作为PSA的一个辅助指标,以减少不必要的穿刺。此外,TZPSAD也可作为判断前列腺癌预后的一个潜在指标。
PURPOSE: To evaluate the value of prostatic volume-adjusted PSA derivatives in the diagnosis of prostate cancer to reduce unnecessary prostate biopsy. Methods: A total of 374 patients who underwent perineal 10-pin prostatic puncture in our hospital from January 1, 2014 to October 31, 2015 were enrolled in this study. The age, PSA, total prostate volume, Ultrasound findings and other indicators, and calculated by the PSA density (PSAD), the density of the outer gland (PZPSAD) and gonadal density (TZPSAD). Patients were divided into subgroups according to PSA criteria or transrectal ultrasound results for comparison. On the puncture specimens for pathological examination to determine the diagnosis and grading of prostate cancer. RESULTS: Of the 374 patients, 164 (43.9%) were diagnosed with prostate cancer, of whom 136 (36.4%) had PSA ≤ 10 μg / L and 154 (41.2%) had suspicious findings in transrectal ultrasound . In all subgroups, TZPSAD is superior to PSAD and PZPSAD in the ability to diagnose prostate cancer, and TZPSAD also increases as the prostate cancer grade increases. Conclusion: TZPSAD can be used as an adjunct to PSA in the decision-making of clinical prostate biopsy to reduce unnecessary puncture. In addition, TZPSAD can also be used as a potential indicator of the prognosis of prostate cancer.