论文部分内容阅读
目的:探讨血清前列腺特异性抗原(PSA)系列及穿刺组织活检Gleason评分在前列腺癌病理分期的预测价值。方法:回顾性分析我院1999～2008年病理证实为前列腺腺癌的124例患者资料,将该124例患者根据术后病理、骨扫描和CT或MRI结果分为A、B两组。骨扫描、CT、MRI或术后证实为有周围浸润或远处转移者归为A组;无周围浸润且无远处转移者归为B组。比较两组之间以上各指标的差异。通过多因素回归分析筛选前列腺癌病理分期的影响因子。运用工作特征曲线(ROC曲线)比较各指标的预测价值。结果:tPSA、穿刺活检Gleason评分值A组明显高于B组(P<0.05);多元Logistic回归分析中,仅tPSA进入模型,被认为是最主要的预测因子。ROC曲线对前列腺病理分期预测效力比较:联合分析tPSA与穿刺活检Gleason评分预测效果明显高于其他指标,工作特征曲线下面积(AUC)从大到小依次为Gleason评分+tPSA>tPSA>PSAD+tPSA+Gleason评分。结论:tPSA依然是临床上对前列腺癌病理分期较好的预测因素;联合穿刺组织活检Gleason评分,可以提高预测准确度,对指导临床治疗和预后有重要意义。
Objective: To investigate the predictive value of serum prostate specific antigen (PSA) series and biopsy Gleason score in the pathological stage of prostate cancer. Methods: A retrospective analysis of 124 patients with pathologically confirmed prostate adenocarcinoma from 1999 to 2008 in our hospital was performed. The 124 patients were divided into A and B groups according to postoperative pathology, bone scan and CT or MRI findings. Bone scan, CT, MRI or postoperative confirmed as having peripheral infiltration or distant metastasis were classified as group A; no peripheral infiltration and no distant metastasis were classified as group B. Differences between the above two indicators were compared. Factors influencing the pathological staging of prostate cancer were screened by multivariate regression analysis. Using the working characteristic curve (ROC curve) to compare the predictive value of each indicator. Results: Gleason scores of tPSA and biopsy in group A were significantly higher than those in group B (P <0.05). In multivariate logistic regression analysis, only tPSA was considered as the predominant predictor. The predicted effect of ROC curves on the staging of prostate cancer: The predictive value of combined analysis of TPSA and Gleason score of biopsy was significantly higher than other indexes. The area under the working characteristic curve (AUC) was Gleason score + tPSA> tPSA> PSAD + tPSA + Gleason score. Conclusion: tPSA is still a clinical predictor of the pathological stage of prostate cancer. Combined with Gleason score of biopsy can improve the prediction accuracy, which is of great significance for guiding the clinical treatment and prognosis.