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目的 研究体检人群不同年龄分层中的血清总前列腺特异性抗原(tPSA)水平分布情况以及不同tPSA水平的穿刺活检阳性率.方法 2009年7月-2010年7月间在本院进行体检的患者8818例检测的tPSA值以及其中40名接受经直肠前列腺穿刺活检的患者的穿刺结果.用直线回归方法计算年龄同tPSA之间的关系,并用卡方检验的方法比较不同年龄组患者之间tPSA水平分布以及不同PSA水平患者之间穿刺活检阳性率的统计学差异.结果 体检人群在tPSA＞4μg/L组的例数和比例在增加,40岁～组为1.4％,50岁～组为1.9％,60岁～组为9.2％,70岁～组为15.5％,＞80岁为17.0％.通过卡方检验得出不同年龄组之间tPSA ＞4 μg/L的患者比例的差异有统计学意义(P＜0.05).通过直线回归分析发现,年龄与tPSA之间的直线相关性r为0.196.接受穿刺患者共40例,研究发现穿刺活检阳性率随tPSA升高增加,tPSA＞ 20 μg/L组共6人,穿刺阳性率为83.3％(5/6),tPSA 10～20 μg/L组共10人,穿刺阳性率为50.0％(5/10),tPSA 4～10 μg/L组阳性率为24.0％(6/25).不同的年龄分层组之间的穿刺阳性率之间相比,差异也有统计学意义(P=0.048).结论 体检人群中tPSA水平同年龄呈正相关,但是没有明显的线性关系.随着年龄增加,tPSA在4 μg/L以上的患者比例随之增加.随tPSA升高,经直肠前列腺穿刺活检率也升高.

Objective To study serum level of prostate specific antigen (PSA) by age and its relationship with positive prostatic biopsy.Methods A total of 8818 adults who underwent PSA scanning at Health Chek-up Center of Beijing Hospital during July 2009 and July 2010 were retrospectively studied,40 of whom performed prostatic biopsy.Linear regression was used to assess the relation of PSA with age,while Chi-square test was used to compare positive prostatic biopsy in different PSA groups.Results Serum PSA of more than 4 μg/L was more commonly seen in the elderly group (40 ～ year-old group 1.4％,50 ～ yearold group 1.9％,60 ～ year-old group 9.2％,70 ～ year-old group 15.5％,80 year-old group 17％ ; P ＜0.001 ; RR =0.196).In those whose PSA was ＞ 20 μg/L,6 (83.3 ％) were found to have positive prostatic biopsy; and the figure was 10 (50.0％) or 24 (24.0％) when PSA was ＜4 μg/L or 4-10 μg/L group (P =0.048).Conclusions Age was positively correlated with PSA,although no linear correlation was confirmed.Higher serum PSA level (＞ 4 μg/L) may be more common in elderly people and those with a positive prostatic biopsy.