血清PSA水平与前列腺穿刺标本中前列腺癌Gleason分级的关联性研究

Study on the Correlation between Serum PSA Levels and Gleason Grading of Prostate Cancer in Prostate Biopsy Specimens

摘要: 目的：探讨血清前列腺特异性抗原(PSA)水平与前列腺穿刺标本中前列腺癌Gleason分级的关联性，为前列腺癌的早期诊断、风险分层及治疗决策提供病理学依据。方法：回顾性分析2024年8月至2025年7月我院病理科收治的100例前列腺穿刺标本，分为良性50例为良性组，恶性50例为恶性组，采用电化学发光法检测血清PSA水平，结合病理组织学检查确定Gleason分级，通过多因素Logistic回归模型分析PSA水平与Gleason分级的关联性。结果：两组患者年龄分布无显著差异(P > 0.05)，但恶性组血清PSA水平显著高于良性组(P < 0.05)。恶性组50例患者中，高分化(Gleason ≤ 6分) 18例，中分化(7分) 22例，低分化(≥8分) 10例。随着Gleason分级升高，血清PSA水平呈递增趋势，三组间差异均有统计学意义(P < 0.05)。以Gleason分级为因变量，纳入血清PSA水平、年龄为自变量进行多因素Logistic回归分析。显示血清PSA水平是Gleason分级升高的独立危险因素(P < 0.05)，年龄无显著影响(P > 0.05)。结论：血清PSA水平与前列腺穿刺标本中前列腺癌Gleason分级呈正相关，是Gleason分级升高的独立危险因素，可为前列腺癌的早期诊断、风险分层及治疗决策提供病理学依据。

Abstract: Objective: To investigate the correlation between serum prostate-specific antigen (PSA) levels and Gleason grading of prostate cancer in prostate biopsy specimens, and to provide pathological basis for early diagnosis, risk stratification, and treatment decision-making of prostate cancer. Method: A retrospective analysis was conducted on 100 prostate puncture specimens admitted to the Pathology Department of our hospital from August 2024 to July 2025. The specimens were divided into a benign group (50 cases) and a malignant group (50 cases). The serum PSA level was detected by electrochemiluminescence, and the Gleason grading was determined by histopathological examination. The correlation between PSA level and Gleason grading was analyzed using a multiple factor logistic regression model. Result: There was no significant difference in age distribution between the two groups of patients (P > 0.05), but the serum PSA level in the malignant group was significantly higher than that in the benign group (P < 0.05). Among the 50 patients in the malignant group, 18 were highly differentiated (Gleason ≤ 6 points), 22 were moderately differentiated (7 points), and 10 were poorly differentiated (≥8 points). As Gleason grading increases, serum PSA levels show an increasing trend, and the differences between the three groups are statistically significant (P < 0.05). Perform multiple logistic regression analysis with Gleason grading as the dependent variable and serum PSA level and age as independent variables. Serum PSA levels were shown to be an independent risk factor for Gleason grading elevation (P < 0.05), with no significant effect from age (P > 0.05). Conclusion: Serum PSA levels are positively correlated with Gleason grading of prostate cancer in prostate biopsy specimens, and are an independent risk factor for elevated Gleason grading. They can provide pathological basis for early diagnosis, risk stratification, and treatment decision-making of prostate cancer.