摘要目的 分析血清PSA、直肠指检(DRE)与前列腺癌检出率、临床分期以及病理分级的相关性. 方法 回顾性分析1997年1月至2010年12月796例PSA、DRE和病理结果完整患者的前列腺穿刺活检资料,采用Spearman相关性研究分析PSA和DRE与前列腺癌相关指标间的关系,进一步将PSA及DRE分组后进行比较. 结果 PSA与前列腺癌检出率、临床分期及病理分级相关(r=0.537,P＜0.0001；r=0.365,P＜0.0001；r=0.556,P＜0.0001)；DRE结果与前列腺癌诊断率及病理分级有相关性(r=0.212,P＜0.0001；r=0.126,P=0.02).分组分析显示不同PSA水平组中前列腺癌检出率、前列腺癌分期以及Gleason评分差异有统计学意义(P＜0.05).而在相同PSA水平时,只有PSA 10.0 ～ 19.9 μg/L组和20.0～99.9μg/L组中DRE阳性和阴性患者的前列腺癌检出率差异有统计学意义(P＜0.05).相同PSA组中不同DRE结果患者的前列腺癌分期以及Gleason评分差异无统计学意义(P＞0.05). 结论 PSA水平与前列腺癌的检出率、肿瘤分期及Gleason评分有显著相关性,DRE结果仅在部分PSA水平患者中影响肿瘤检出率.

abstractsObjective To evaluate the influences of prostate-specific antigen (PSA) and digital rectal examination (DRE) to the detection rate,stage and Gleason grade of prostate cancer.Methods Retrospective analysis was performed on the prostate biopsy data of Beijing hospital from January 1997 to December 2010.The spearman rank correlation was applied to evaluate the relationship of PSA and DRE to the parameters related to the prostate cancer.Results The PSA had significant correlation with cancer detection rate,stage and Gleason grade (r =0.537,P ＜0.0001; r =0.365,P ＜0.0001; r=0.556,P ＜0.0001).However,DRE had only correlation with cancer detection rate and Gleason grade (r =0.212,P ＜0.0001 ; r =0.126,P =0.02).As the PSA increased,when divided into different groups,the cancer detection rate and the proportion of patients with Gleason 7-10 increased whereas the localized cancer rate decreased.DRE positive patients had higher cancer detection rate when PSA was in 10.0-19.9 μg/L and 20.0-99.9 μg/L groups.The DRE results had no influence to the stage or Gleason grade in same PSA group.Conclusions PSA has significant correlation with prostate cancer detection rate,stage and Gleason grade.However,the DRE results only affect cancer detection rate in some PSA level.