前列腺癌血清PSA\PSAD与Gleason评分\临床分期的相关性研究(1)
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【摘要】 目的 探讨前列腺癌病人血清PSA、PSAD (血清总PSA与前列腺体积PV的比值)与前列腺癌Gleason评分、临床分期的相关性。方法 回顾分析2003年1月一2009年4月我科收治的106例前列腺癌患者资料,建立临床资料数据库。采用Spearman等级相关分析,分析血清PSA、PSAD与前列腺癌Gleason评分、临床分期的关系。结果 106例前列腺癌中,前列腺癌PSA值与Gleason评分呈正相关(r=0.286,P<0.01),与前列腺癌临床分期呈正相关(r=0.549,P<0.01); PSAD与Gleason评分无相关(r=0.120,P>0.05);PSAD值与前列腺癌临床分期无相关(r=0.060,P>0.05)。结论 血清PSA、PSAD与前列腺癌预后密切相关的指标临床分期和Gleason评分有关。
【关键词】 前列腺癌;前列腺特异性抗原PSA;Gleason评分;临床分期
【中图分类号】R335.+5 【文献标识码】 B 【文章编号】1005-0515(2010)007-027-02
Relationship of serum PSA, PSAD and Gleason score,clinical stage in patients with prostate cancer
Tao Lingzhi,Lai Yongqing Shi Bentao Guan Zhichen
(Department of Urology, Peking University Shenzhen Hospital,Guangdong,Shenzhen)
【Abstract 】Objective:To evaluate the relationships among Gleason score,clinical stage and total PSA,PSAD in patients with prostate cancer. Menthods:A survey has been made on inpatients with prostate cancer diagnosed by pathology from January 2003 to April 2009 in the Peking University Shenzhen Hospital. Gleason score and clinical stage were determined on the basis of pathological examination and clinic martial in prostate cancer patients.Spearman rank correlation was applied to evaluate the relationship between Gleason score,clinical stage and total PSA,PSAD. Results:In 106 cases of prostate cancer,total PSA was significantly positively corelated with Gleason score(r=0.286,P<0.01),and clinical stage(r=0.549,P<0.01). PSAD was no corelated with Gleason score(r=0.120,P>0.05),and clinical stage(r=0.060,P>0.05).Conclusion: Serum total PSA and PSAD are corelated with Gleason score and clinical stage which are predictors of prognosis in prostate cancer.
【Key words】prostate cancer prostate specific antigen(PSA); Gleason score;clinical stage.
作为前列腺癌的筛选指标,血清前列腺特异性抗原PSA检测在临床中广泛应用。肿瘤临床分期和Gleason评分往往与患者预后密切相关,至于PSA与患者预后是否有关尚不清楚。此外,对国人PSA、PSAD与前列腺癌Gleason评分、临床分期的关系报道较少。本研究旨在探讨我院2003年1月一2009年4月收治的前列腺癌患者血清PSA水平、PSAD值与其Gleason评分和临床分期的相关性。
资料与方法
一、临床资料
回顾分析2003年1月一2009年4月我科收治的106例前列腺癌患者资料,建立临床资料数据库。病人年龄48-81岁,中位年龄68岁。其中PSA<4 ng/ml 16例(15%),4-10ng/ml 20例(19%), PSA> 10 ng/ml 70例(66%)。PSAD平均值为(1.31±2.88)。临床分期A期37例(35%),B期14例(13%),C期14例(13%),D期41例(39%)。病理标本Gleason评分<7分33例(31%),Gleason评分=7分25例(24%),Gleason评分>7分48例(45%)。
二、Gleason评分和临床分期方法
全部标本(活组织检查、经尿道切除的组织、根治性前列腺切除标本)经常规HE染色制成切片,对病理切片应用Gleason分级系统对前列腺癌进行组织学分级,分5级10分。根据Gleason评分将前列腺癌分为3组,低危组(Gleason<7分),中危组(Gleason=7分),和高危组(Gleason>7分) ......
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