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目的:评估前列腺特异抗原密度(prostate specific antigen density,PASD)对前列腺癌根治术后不良病理结果的预测价值。方法:回顾性分析50例病理确诊为前列腺癌患者的临床资料,收集患者术前总前列腺特异抗原(total prostate specific antigen,tPSA)、PSAD及穿刺活检Gleason评分结果,比较在手术切缘阳性(positive surgical margins,PSM)、前列腺包膜外侵犯(extracapsular prostatic extension,EPE)、精囊入侵(seminal vesicle invasion,SVI)患者中以上各项指标的差异,对有统计学差异的因素行多元Logistic回归分析,筛选影响浸润的最主要因素,同时运用工作特征曲线(ROC曲线)比较各指标的预测价值。结果:PSM,EPE和SVI患者之间PSAD存在统计学差异,PSAD曲线下面积高于PSA与Gleason评分。多元Logistic回归分析结果表明,PSAD和Gleason评分对PSM和EPE有着统计学意义的预测价值,且PSAD和PSA与SVI有关。结论:PSAD可作为接受前列腺癌根治术的患者术后不良的预测指标。
Objective: To evaluate the predictive value of prostate specific antigen density (PASD) in the detection of adverse pathological findings after radical prostatectomy. Methods: The clinical data of 50 patients with pathologically diagnosed prostate cancer were retrospectively analyzed. The total preoperative prostate specific antigen (tPSA), PSAD and Gleason score of biopsy were collected. The positive rate of positive prostatectomy surgical margins (PSM), extracapsular prostatic extension (EPE), and seminal vesicle invasion (SVI) .Multivariate logistic regression analysis was performed on statistically significant factors, The most important factors affecting the infiltration were screened, and the working characteristic curve (ROC curve) was used to compare the predictive value of each index. Results: There was a significant difference in PSAD between PSM, EPE and SVI patients, and the area under PSAD curve was higher than PSA and Gleason score. Multivariate logistic regression analysis showed that PSAD and Gleason scores had statistically significant predictive value for PSM and EPE, and PSAD and PSA were related to SVI. Conclusions: PSAD can be used as a predictor of poor postoperative outcomes in patients undergoing radical prostatectomy.