切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (03) : 154 -158. doi: 10.3877/cma.j.issn.1674-3253.2018.03.003

所属专题: 文献

临床研究

血清前列腺特异性抗原预测中国男性前列腺增生患者前列腺体积的准确性研究
杨文俊1, 胡成2, 刘思容1, 汤平1, 欧汝彪1, 韦兴华1, 谢克基1,()   
  1. 1. 510180 广州市第一人民医院泌尿外科
    2. 510630 广州,中山大学附属第三医院泌尿外科
  • 收稿日期:2018-01-19 出版日期:2018-06-01
  • 通信作者: 谢克基
  • 基金资助:
    广州市医药卫生科技项目(20172A010002)

Accuracy of serum tPSA, fPSA in predicting prostate volume of Chinese LUTS/BPO-a single center study

Wenjun Yang1, Cheng Hu2, Sirong Liu1, Ping Tang1, Rubiao Ou1, Xinghua Wei1, Keji Xie1,()   

  1. 1. Department of Urology, Guangzhou First People's Hospital, Guangzhou 510180, China
    2. Department of Urology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China
  • Received:2018-01-19 Published:2018-06-01
  • Corresponding author: Keji Xie
  • About author:
    Corresponding author: Xie Keji, Email:
引用本文:

杨文俊, 胡成, 刘思容, 汤平, 欧汝彪, 韦兴华, 谢克基. 血清前列腺特异性抗原预测中国男性前列腺增生患者前列腺体积的准确性研究[J]. 中华腔镜泌尿外科杂志(电子版), 2018, 12(03): 154-158.

Wenjun Yang, Cheng Hu, Sirong Liu, Ping Tang, Rubiao Ou, Xinghua Wei, Keji Xie. Accuracy of serum tPSA, fPSA in predicting prostate volume of Chinese LUTS/BPO-a single center study[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(03): 154-158.

目的

通过比较血清总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)与年龄预测前列腺体积(PV)大小的准确性,寻找预测PV简便易行、较准确的预测因子。

方法

收集2005年1月至2014年12月因下尿路症状到我院诊治下尿路症状/良性前列腺梗阻(LUTS/BPO)患者的年龄、PV及PSA检测值;采用SPSS 13.0软件处理数据,用皮尔森线性相关关系描述年龄、血清tPSA及血清fPSA与PV的相关性,并采用卡方检验及受试者特征曲线(ROC)分析比较血清tPSA、血清fPSA预测PV的准确性。

结果

入选6 308例男性,皮尔森线性相关分析显示年龄-PV、tPSA-PV和fPSA-PV的相关系数分别是0.197、0.434、和0.446,其P值均<0.05,具有相关性;在tPSA为0~4 μg/L时,tPSA和fPSA预测PV在(30~50)ml、(50~70)ml和PV>70 ml组的AUC-ROC分别为(0.617、0.732、0.761)和(0.625、0.738、0.767);在tPSA为0~4 μg/L时,tPSA和fPSA预测PV在(30~50)ml、(50~70)ml和PV>70 ml组的最佳临界值分别为tPSA(1.3 μg/L、1.6 μg/L、2.0 μg/L)和fPSA(0.3 μg/L、0.4 μg/L、0.5 μg/L)。

结论

中国LUTS/BPO男性血清fPSA与PV正相关程度最高,血清tPSA与fPSA均可作为独立预测因子预测中国LUTS/BPO男性的PV,可作为临床上预测PV简便易行的指标,其中fPSA预测的准确性更高。

Objective

To compare the accuracy of serum total prostate-specific antigen (tPSA), free PSA (fPSA) and age in predicting prostate volume (PV), aiming to identify the simple and accurate biomarkers for predicting PV.

Methods

Age, PV, and PSA values of patients diagnosed with lower urinary tract symptoms/benign prostatic obstruction (LUTS/BPO) admitted to our hospital from January 2005 to December 2014 were collected. The data was processed using SPSS 13.0 statistical software. Pearson's linear correlation was utilized to describe the correlation between age, serum tPSA, serum fPSA and PV. Chi-square test and the receiver characteristic curve (ROC) were used to analyze and compare the accuracy of serum tPSA and fPSA in predicting PV.

Results

A total of 6308 male patients were enrolled. Pearson's linear correlation analysis demonstrated that the correlation coefficients of age-PV, tPSA-PV and fPSA-PV were 0.197, 0.434, and 0.446, respectively (all P<0.05). When tPSA was 0-4 μg/L, the AUC-ROC of tPSA and fPSA in predicting PV in the (30-50), (50-70) and >70 ml groups were (0.617, 0.732, 0.761) and (0.625, 0.738, 0.767), respectively. When tPSA was 0-4 μg/L, the optimal cut-off values of tPSA and fPSA in predicting PV in the (30-50), (50-70), and PV> 70 ml groups were (1.3 μg/L, 1.6 μg/L, 2.0 μg/L)and (0.3 μg/L, 0.4 μg/L, 0.5 μg/L), respectively.

Conclusions

The serum fPSA possesses the highest positive correlation with PV in the male LUTS/BPO patients in China. Serum tPSA and fPSA can be considered as independent biomarkers to predict the PV in this population, which can be used as simple and convenient predictors for PV in clinical practice. fPSA yields higher prediction accuracy compared with tPSA.

图3 血清FPSA与PV的相关性,相关系数r=0.446,拟合度R=0.279
图4 血清tPSA、血清fPSA预测PV≤30 ml的ROC曲线下面积
图5 血清tPSA、血清fPSA预测PV30~50 ml的ROC曲线下面积
图6 血清tPSA、血清fPSA预测PV50~70 ml的ROC曲线下面积
图7 血清tPSA、血清fPSA预测PV>70 ml的ROC曲线下面积
[1]
徐骏,钱伟庆,宋建达. 比较不同剂量舍尼通在防止良性前列腺增生疾病进程中的作用[J]. 中华男科学杂志, 2008, 14(6): 533-537.
[2]
Filson CP,Hollingsworth JM,Clemens JQ, et al. The efficacy and safety of combined therapy with a-blockers and anticholinergics for men with benign prostatic hyperplasia: a meta-analysis[J]. J Urol, 2013, 190(6): 2153-2160.
[3]
Mochtar CA,Kiemeney LA,van Riemsdijk MM, et al. Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia[J]. Eur Urol, 2003, 44(6): 695-700.
[4]
Park DS,Oh JJ,Hong JY, et al. Serum prostate-specific antigen as a predictor of prostate volume and lower urinary tract symptoms in a community-based cohort: a large-scale Korean screening study[J]. Asian J Androl, 2013, 15(2): 249-253.
[5]
De Nunzio C,Autorino R,Bachmann A, et al. The diagnosis of benign prostatic obstruction: Development of a clinical nomogram[J]. Neurourol Urodyn, 2016, 35(2): 235-240.
[6]
Coric J,Mujic J,Kucukalic E, et al. Prostate-specific antigen(PSA)and prostate volume:better predictor of prostate cancer for bosnian and Herzegovina men[J]. Open Biochem J, 2015, 15(9): 34-36.
[7]
Pejcic TP,Tulic CDz,Lalic NV, et al. Urinary prostate-specific antigen: predictor of benign prostatic hyperplasia progression[J]. Can J Urol, 2013, 20(2): 6707-6713.
[8]
Schröder FH,Hugosson J,Roobol MJ, et a1. Prostate cancer mortality at 11 years of follow-up[J]. N Engl J Med, 2012, 366(11): 981-990.
[9]
Bohnen AM1,Groeneveld FP,Bosch JL. Serumprostate-specific antigen as a predictorof prostate volume in the community: the Krimpen study[J]. Eur Urol, 2007, 51(6): 1645-1652.
[10]
Park DS1,Oh JJ,Hong JY, et al. Serum prostate-specific antigen as a predictor of prostate volume and lower urinary tract symptoms in a community-based cohort: a large scale Korean screening study[J]. Asian J Androl, 2013, 15(2): 249-253.
[11]
Bansal A,Arora A. Predictors of successful trial without catheter following acute urinary retention in benign prostatic enlargement: A single centre, multivariate analysis[J]. Neurourol Urodyn, 2017, 36(7): 1757-1762.
[12]
Yoshida T,Kinoshita H,Yoshida K, et al. Intravesical prostatic protrusion as a predicting factor for the adverse clinical outcome in patients with symptomatic benign prostatic enlargement treated with dutasteride[J]. Urology, 2016 ,91(1):154-157.
[13]
Ho CC,Ngoo KS,Hamzaini AH, et al. Urinary bladder characteristics via ultrasound as predictors of acute urinary retention in men with benign prostatic hyperplasia[J]. Clin Ter, 2014, 165(2): 75-81.
[14]
Choi H,Park JY,Shim JS, et al. Free prostate-specific antigen provides more precise data on benign prostate volume than total prostate-specific antigen in Korean population[J]. Int Neurourol J, 2013, 17(2): 73-77.
[15]
Kayikci A,Cam K,Kacagan C, et al. Freeprostate-specific antigen is a better tool than total prostate-specific antigen at predicting prostate volume in patients with lower urinary tract symptoms[J]. Urology, 2012, 80(5): 1088-1092.
[1] 熊风, 林辉煌, 陈晓波. 铥激光在泌尿外科中的临床应用及研究进展[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(05): 533-536.
[2] 韩广玮, 申雪晴, 吴涵潇, 曹炎武, 唐黎明. 前列腺增生并轻度尿道狭窄行去外鞘半导体激光汽化剜除与等离子电切的比较[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(05): 490-494.
[3] 李全喜, 唐辉军, 唐友杰, 杨飞. DISCO成像技术在前列腺增生与前列腺癌鉴别诊断中的应用价值[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(04): 332-335.
[4] 赖良海, 赵伟, 肖云新, 杨伟明, 陈光耀. 1 470 nm激光"平均三分法"剜除术与等离子剜除术治疗前列腺增生的比较[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(03): 252-256.
[5] 李国峰, 李显文, 周祥福, 何昊麟, 杜红兵, 宾开云. 单极滚珠电极与等离子行经尿道前列腺剜除术的比较[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(03): 247-251.
[6] 游猛, 顾志文, 宋生生, 张贺庆, 詹河涓. 等离子电切术与钬激光剜除术治疗体积>80 ml前列腺增生的比较[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(01): 44-49.
[7] 邹志辉, 张礼刚, 胡永涛, 牛迪, 陈佳, 葛秦涛, 尹水平, 杨诚, 施浩强, 邰胜, 周骏, 郝宗耀, 梁朝朝. 无线智能高清内镜在经尿道双极等离子解剖性前列腺剜除术中的应用初探[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(01): 39-43.
[8] 顾志波, 苏倩, 陈建刚, 陆明. 低功率钬激光与等离子剜除治疗中等体积前列腺增生的比较[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(06): 496-500.
[9] 邹志辉, 张礼刚, 梁朝朝. 电外科和激光平台等技术在前列腺增生日间手术中的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(06): 489-495.
[10] 黄展森, 狄金明. 2022版欧洲泌尿外科学会前列腺癌诊疗指南更新要点解读[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(06): 483-488.
[11] 万颂, 华伟, 兰红梅, 骆正馨, 万跃平. 前列腺钬激光整块剜除术与经尿道前列腺电切术治疗前列腺增生的比较[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(05): 427-431.
[12] 董毅, 杨濛, 王正, 江爱民, 张宗勤, 吴震杰, 王林辉, 徐红, 刘冰. 经尿道等离子杆状电极解剖性前列腺剜除术的手术经验与临床疗效[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(05): 413-418.
[13] 许立哲, 夏煜琦, 程帆. 前列腺尿道悬吊术治疗前列腺增生的进展[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(05): 385-388.
[14] 张宁, 张梦菲, 邱建新, 高闫尧, 陈育, 高靖榆. 腹腔镜下经尿道等离子电切术联合疝环充填式无张力疝修补术治疗腹股沟斜疝合并前列腺良性增生[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(04): 441-444.
[15] 姚雄宇, 董秀哲, 李晓刚, 张恩浩, 侯国军. 布鲁菌病致前列腺炎合并脊柱炎一例并文献复习[J]. 中华临床医师杂志(电子版), 2023, 17(05): 624-626.
阅读次数
全文


摘要