摘要
目的了解北京地区50岁以上体检人群PSA水平及分布情况。方法选取2010年1—12月50岁以上男性体检人群2862例。年龄50～89岁，平均（67．2±9．3）岁。具有既往3年的PSA检查结果。排除前列腺癌及严重心、脑、肺、肝、肾等内脏疾病，精神、神经障碍，阿尔茨海默症以及由于各种原因不能配合调查者。PSA〉4μg／L者241例（8．5％），其中4μg／L≤PSA〈10μg／L者209例（7．4％），PSA≥10μg／L者32例（1．1％）。结果2862例研究对象中，随着年龄增长，PSA异常者的比例由2．7％上升至10．9％，差异具有统计学意义（P〈0．05）。共有86例PSA水平肆常者接受了前列腺穿刺活检，占PSA水平异常者的33．2％；在接受穿刺活检者中，穿刺阳性者39例（41．4％），穿刺阳性率随PSA水平上升而升高。PSA〈4μg／L组穿刺阳性率为25．0％，4μg／L≤PSA〈10μg／L组为29．8％，PSA≥10μg／L组为68．9％，组间差异具有统计学意义（P〈0．05）。随PSA水平的增高，局限性肿瘤比例由100％下降至70％，肿瘤局部及远处转移比例由0升高至30％；Gleason≤6比例由100％下降至30％，Gleason≥8比例由0上升至50％，但差异均无统计学意义（P〉0．05）。结论对50岁以上男性进行PSA筛查能够提高前列腺癌的检出率；目前在北京地区，大部分PSA水平异常者尚小愿接受有创的医学检查。
Objective To study the role of using PSA in prostate cancer screening in the male phys-ical examination population over 50yrs in Beijing. Methods From January 2010 to December 2010, in Physical Examination Center of Beijing Hospital and Beijing MeiZhao Health Screening Center, men over 50 years with PSA records in the past three years （ from 2007. to 2009） were selected. The exclusion criteria in-cluded history of prostate cancer, severe diseases of the heart, brain, lung, liver and kidney, and mental or neurological disorders. People who couldn＇t cooperate with the investigation due to any reasons were exclu-ded as well. The number of recruited cases was 2862. Among the cases, males with PSA over 4 μg/L re-ceived prostate biopsy after singing the informed consent form. The average age was 67.2 ＋ 9.3 years. Results in the 2862 males, 2621 cases （91.5%） had normal PSA levels and 241 cases （8. 5% ） had ab-normal PSA levels. With the age increasing from 50 to 89 years, the proportion of abnormal PSA levels in-creased significantly from 2.7% to 10.9% , P 〈 0. 001. 86 patients （33.2%） received prostate biopsy in the group of abnormal PSA levels; The positive prostate biopsy rate was 41.4% （39/86）. In PSA 〈 4 μg/L group, the positive rate was 25.0% ; in 4 μg/L≤PSA 〈 10 μg/L group, the positive rate was 29.8% ; in PSA ≥ 10 Ixg/L group, the positive rate was 68.9% , P 〈 0. 001. With the PSA level increasing, the propor-tion of the localized cancer decreased from 100% to 70% i and the ratio of locally advanced and distant me-tastatic tumor increased from 0 to 30% ; the proportion of Gleason≤6 fell from 100% to 30% , the propor-tion of Gleason≥8 increased from 0 to 50%. The differences above did not show statistical significance. Conclusions Use of PSA in prostate cancer screening for men over 50 years could increase the detection rate of prostate cancer.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2013年第6期462-465,共4页
Chinese Journal of Urology
基金
首都临床特色应用研究项目（Z121107001012155）首都医学发展科研基金项目（2009-3019）
