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目的探讨血清前列腺特异抗原(PSA)联合分级对前列腺癌患者的分期进行预测的方法。方法回顾分析我院泌尿外科187例穿刺活检诊断为前列腺癌患者的临床资料。采用等级相关分析、秩和检验、逐步判别多因素分析方法,分析血清PSA水平、游离PSA百分比(FPSA/TPSA值)与Gleason评分(GS)、分期的关系。结果前列腺癌患者GS越高,血清PSA水平越高(r=0.369,P<0.001)。分期越晚,血清PSA、GS越高(r=0.398,0.530,P均<0.001)。FPSA/TPSA值与分期不相关(P>0.70),但当PSA≤10μg/L时,FPSA/TPSA值与分期呈负相关(r=-0.600,P<0.05)。当PSA>20μg/L时,67%~87%的患者可能为C或D期。用PSA、GS预测分期的公式为x=-3.488+0.041×PSA+0.428×GS。结论血清PSA水平与GS呈正相关。血清PSA水平、GS分别与分期呈正相关。当PSA≤10μg/L时,FPSA/TPSA值与分期呈负相关。运用判别公式x=-3.488+0.041×PSA+0.428×GS可以预测前列腺癌患者的分期。
Objective To explore the method of predicting the staging of patients with prostate cancer by combining serum PSA with prostate cancer. Methods Retrospective analysis of our hospital urology 187 cases of biopsy diagnosis of prostate cancer in patients with clinical data. The rank correlation analysis, rank sum test and stepwise discriminant multivariate analysis were used to analyze the relationship between serum PSA level, percentage of free PSA (FPSA / TPSA) and Gleason score (GS) and staging. Results The higher the GS of prostate cancer patients, the higher the serum PSA level (r = 0.369, P <0.001). The later the stage, serum PSA, GS higher (r = 0.398,0.530, P <0.001). There was no correlation between FPSA / TPSA and staging (P> 0.70). However, there was a negative correlation between FPSA / TPSA and staging when PSA≤10μg / L (r = -0.600, P <0.05). When PSA> 20μg / L, 67% to 87% of patients may be C or D period. The formula for predicting staging with PSA and GS is x = -3.488 + 0.041 × PSA + 0.428 × GS. Conclusions Serum PSA level is positively correlated with GS. Serum PSA levels, GS were positively correlated with staging. When PSA≤10μg / L, FPSA / TPSA value was negatively correlated with staging. Using the discriminant formula x = -3.488 + 0.041 × PSA + 0.428 × GS can predict the staging of patients with prostate cancer.