年龄及PSA对检出前列腺癌的影响

Effects of Age and PSA on the Positive Rate of Prostate Cancer Biopsy

摘要: 目的：探讨年龄、前列腺特异性抗原(prostate specific antigen, PSA)不同组合时对前列腺癌(Prostate Cancer, PCa)检出的影响，分析年龄和PSA的相关性。方法：连续回顾性分析2016年7月至2019年9月于我院怀疑为前列腺癌并行超声引导下经直肠前列腺穿刺的患者，共83例。收集年龄、前列腺体积、PSA、穿刺针数和病理结果等相关资料。患者按照年龄分为<70岁和≥70岁组，按照PSA分为<20 ng/ml和≥20 ng/ml组。利用χ²检验判断年龄及PSA对提高前列腺癌检出有无影响，年龄和PSA相关性分析采用皮尔逊相关性分析。结果：年龄 < 70岁组和≥70组前列腺癌阳性率有统计学差异(p < 0.010)；PSA < 20 ng/ml和≥20 ng/ml组前列腺癌阳性率有统计学差异p = 0.015 (p < 0.05)；年龄 ≥ 70岁并且PSA ≥ 20 ng/ml组前列腺癌阳性率与年龄 < 70岁并且PSA < 20 ng/ml有统计学差异p = 0.001 (p < 0.008)。年龄与PSA成正相关关系，相关系数为0.298，p = 0.006 (p < 0.05)，前列腺癌患者和非前列腺癌患者年龄和PSA不存在相关性，p分别为0.213，0.653 (p > 0.05)。结论：年龄 ≥ 70岁且PSA ≥ 20 ng/ml人群，有较高的前列腺癌阳性率，均应尽早活检，明确诊断，为尽早临床干预提供时机。对其他组人群，应用影像新技术提高前列腺癌阳性率。年龄 < 70岁且PSA < 20 ng/ml人群，应充分结合影像学、其他实验室检查、临床表现及患者意愿综合考虑是否行前列腺穿刺活检，以免进行不必要的穿刺活检。年龄与PSA成正相关，前列腺癌、非前列腺癌患者年龄与PSA无相关关系。

Abstract: Objective: To explore the effect of different combinations of age and PSA on the positive rate of prostate cancer biopsy, and to preliminary analyze the correlation between age and PSA. Methods: A continuous retrospective analysis of 83 patients from July 2016 to September 2019 in our hospital who were suspected of having prostate cancer and ultrasound-guided transrectal prostate puncture. Collect relevant data such as age, prostate volume, PSA, number of puncture needles and pathological results. Patients were divided into groups of <70 years and ≥70 years according to age, and into groups of <20 ng/ml and ≥20 ng/ml according to PSA. Use the χ² test to determine whether age and PSA have an effect on increasing the positive rate of prostate cancer. Pearson’s correlation analysis was used to analyze the correlation between age and PSA. Results: There was a statistically significant difference in the positive rate of prostate cancer between the age group <70 years and ≥70 group (p < 0.010); PSA < 20 ng/ml and ≥20 ng/ml group had a statistically significant difference in prostate cancer positive rate p = 0.015 (p < 0.05); the positive rate of prostate cancer in the group ≥70 years old and PSA ≥ 20 ng/ml was statistically different from the age <70 years old and PSA < 20 ng/ml, p = 0.001 (p < 0.008). Age was positively correlated with PSA, the correlation coefficient was 0.298, p = 0.006 (p < 0.05), there was no correlation between age and PSA in patients with prostate cancer and non-prostate cancer, p was 0.213, 0.653 (p > 0.05). Conclusion: People aged ≥ 70 years and PSA ≥ 20 ng/ml have a higher positive rate of prostate cancer. All should be biopsy as soon as possible to confirm the diagnosis and provide the opportunity for early clinical intervention. For other groups of people, the application of new imaging technology to improve the positive rate of prostate cancer. People aged < 70 years and PSA < 20 ng/ml should fully consider whether to perform prostate biopsy based on imaging, other laboratory tests, clinical manifestations and patient’s wishes, so as to avoid unnecessary biopsy. Age is positively correlated with PSA, and there is no correlation between age of patients with prostate cancer and non-prostate cancer and PSA.