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目的通过对前列腺上皮内瘤(PIN)临床资料分析,探讨PIN的生物特性及应对策略。方法对31例无前列腺癌PIN(NPCaPIN)改变患者(其中1级23例,2、3级8例)的临床资料(包括患者血清PSA、fPSA/tPSA、PSA密度等区域计数资料以及穿刺标本免疫组织化学染色结果)进行回顾性分析,以同期确诊为前列腺癌(PCa)、良性前列腺增生(BPH)患者资料作为对照,分析低级别PIN(LGPIN)和高级别PIN(HGPIN)改变之间及NPCaPIN临床特征与PCa、BPH患者临床特征的差异。结果LGPIN和HGPIN改变的患者之间血清PSA水平和年龄存在差异(P<0.05);LGPIN和PCa患者之间血清PSA水平、前列腺体积、fPSA存在显著差异(P<0.01),PSA密度、fPSA/tPSA比值存在差异(P<0.05),和BPH患者之间各项均无明显差异;HGPIN改变和PCa患者之间前列腺体积、fPSA水平和年龄存在差异(P<0.05),和BPH患者之间血清PSA水平差异显著(P<0.01),fPSA/tPSA比值和年龄(P<0.05)存在差异;NPCaPIN和PCa患者之间血清前列腺体积、fPSA水平和年龄、血清PSA水平、PSA密度存在显著差异(P<0.01),和BPH患者之间fPSA/tPSA比值(P<0.05)存在差异。P63、AE1、AE3、P504S、PSA免疫组织化学结果NPCaPIN组类似于BPH而完全异于PCa。结论LGPIN的临床和病理特征与BPH相似,而HGPIN的临床和病理方面具有一定的前列腺恶性肿瘤特征,需要积极的临床追踪观察。
Objective To investigate the biological characteristics of PIN and its coping strategies by analyzing the clinical data of prostatic intraepithelial neoplasia (PIN). Methods The clinical data of 31 patients with NPC (NPCaPIN), 23 patients in grade 1 and 8 patients in grade 2 and 3 were enrolled in this study. The data of patients including serum PSA, fPSA / tPSA, PSA density, Histopathological staining results were analyzed retrospectively. The data of patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) diagnosed in the same period were used as a control to analyze the relationship between low-grade PIN (LGPIN) and high-grade PIN Clinical characteristics and clinical features of patients with PCa, BPH differences. Results There was significant difference in serum PSA level and age between patients with LGPIN and HGPIN changes (P <0.05), serum PSA level, prostate volume and fPSA were significantly different between LGPIN and PCa patients (P <0.01) (P <0.05). There was no significant difference between BPH patients and HGPIN patients (P> 0.05). There was a significant difference in the level of prostate gland, fPSA and age between HGPIN patients and PCa patients (P <0.05) (P <0.01), and the difference of fPSA / tPSA ratio and age (P <0.05). There was significant difference between PSAa level and age, serum PSA level and PSA density in patients with NPCaPIN and PCa (P <0.01), and there was a difference in fPSA / tPSA ratio (P <0.05) between patients with BPH and those with BPH. P63, AE1, AE3, P504S, PSA Immunohistochemistry Results NPCaPIN group was completely different from PCa, similar to BPH. Conclusions The clinical and pathological features of LGPIN are similar to those of BPH. However, the clinical and pathological features of HGPIN have certain features of prostate cancer and require active clinical follow-up.