摘要
目的探讨前列腺特异性抗原同源异构体2(p2PSA)及其衍生指标前列腺健康指数(PHI)、前列腺健康指数密度(PHID)在前列腺癌诊断中的应用价值。方法收集2020年8月至2021年9月在山东大学附属省立医院行前列腺穿刺术的148例患者病例资料。根据穿刺病理结果将患者分为良性前列腺增生组(n=78)与前列腺癌组(n=70)。术前检测所有患者血清前列腺特异性抗原(PSA)、游离前列腺特异性抗原(fPSA)、p2PSA并计算出前列腺特异抗原密度(PSAD)、PHI和PHID。采用受试者工作特征(ROC)曲线评估各指标诊断前列腺癌的效能;术后病理进行Gleason评分,检测各项指标对高级别前列腺癌(Gleason评分≥7)的预测价值。结果与前列腺增生组比较,前列腺癌组PSA、PSAD、p2PSA、PHI、PHID均明显增高,差异均有统计学意义(P均<0.001)。ROC曲线分析结果显示,PSA、PSAD、p2PSA、PHI及PHID诊断前列腺癌的曲线下面积(AUC)分别为0.68、0.81、0.83、0.88、0.92。p2PSA、PHI及PHID诊断前列腺癌的价值优于PSA(P均<0.001);p2PSA、PHI、PHID诊断高级别前列腺癌的AUC分别为0.75、0.84、0.84,均高于PSA(AUC为0.69),差异均有统计学意义(P=0.026、P=0.009、P=0.028)。结论应用p2PSA、PHI、PHID可以提高前列腺癌诊断的特异性,更准确地预测高级别前列腺癌,对于评估肿瘤的恶性程度、生物学行为及预后有重要意义。
Objective To explore the value of isoform[-2]proprostate-specific antigen(p2 psa),prostate health index(PHI)and prostate health index density(phid)in the diagnosis of prostate cancer.Methods Clinical data of 148 male patients who underwent prostate biopsy in our hospital during Aug.2020 and Sep.2021 were collected.According to the pathological results,the patients were divided into benign prostatic hyperplasia group(BPH,n=78)and prostate cancer group(PCa,n=70).Serum prostate specific antigen(PSA),free prostate specific antigen(fPSA)and p2 PSA were determined before prostate biopsy,and prostate specific antigen density(PSAD),PHI and PHID were calculated.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of various indexes in the diagnosis of prostate cancer.The prostate pathological result was considered as the gold standard to evaluate the Gleason score of PCa patients and detect the value of various indexes in predicting high-grade PCa(Gleason score≥7).Results Compared with BPH group,the PCa group had significantly higher PSA,PSAD,p2 PSA,PHI and PHID(all P<0.001).ROC curve showed that the area under the curve(AUC)of PSA,PSAD,p2 PSA,PHI and PHID in the diagnosis of PCa were 0.68,0.81,0.83,0.88 and 0.92,respectively.The diagnostic value of p2 PSA,PHI and PHID was better than that of PSA(all P<0.001).The AUC of p2 PSA,PHI and PHID in the diagnosis of high-grade PCa were 0.75,0.84 and 0.84,respectively,which were better than that of PSA(AUC=0.69)(P=0.026,P=0.009,P=0.028).Conclusion Detection of p2 psa,PHI and PHID can improve the specificity of prostate cancer diagnosis and accurately predict high-grade prostate cancer.They are significant to evaluate the malignancy,biological behavior and prognosis of the tumor.
作者
许振
刁统祥
臧振杰
邵丁昌
张奇
孙鼎琪
傅强
XU Zhen;DIAO Tongxiang;ZANG Zhenjie;SHAO Dingchang;ZHANG Qi;SUN Dingqi;FU Qiang(Department of Urology,Shandong Provincial Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250021,Shandong,China)
出处
《山东大学学报（医学版）》
CAS
北大核心
2022年第6期51-56,共6页
Journal of Shandong University:Health Sciences
基金
山东省自然科学基金青年项目(ZR20211QH366)
