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目的了解老年男性前列腺疾病的发病情况探讨前列腺特异性抗原(PSA)在前列腺癌诊断中的价值。方法对1234名老年男性进行前列腺指检(DRE)和PSA测定,然后对其中PSA>4.0ng/mL者进行了随访复查,检查项目包括PSA和经直肠前列腺超声,并建议行前列腺穿刺活检。结果1234例调查者中, PSA>4.0ng/ml者146例,其中126例得到随访,并接受了经直肠超声引导下“10点法”前列腺穿刺活检,其中101例前列腺增生患者中,PSA为(8.4±14.2)ng/ml,而25例前列腺癌患者中,PSA明显增高,为(29.3±1 7.5)ng/ml,两组相比差异有统计学意义(P<0.05);101例前列腺增生患者中,所测PV值为(32.61±16.19)ml,而25例前列腺癌患者所测PV值为(36.13±12.73)ml,两者相比差异无明显统计学意义(P>0.05)。比较不同PSA浓度与前列腺癌发生率的关系,PSA>10ng/ml时其前列腺癌的发生率显著高于4ng/ml4.0ng/ml的患者应密切随访复查,并建议行经直肠前列腺穿刺活检。对PSA高于10ng/ml时应高度警惕前列腺癌的发生。
Objective To investigate the incidence of prostate disease in elderly men and to explore the value of prostate-specific antigen (PSA) in the diagnosis of prostate cancer. Methods A total of 1234 elderly men underwent digital rectal examination (DRE) and PSA measurement, and then those with PSA> 4.0 ng / mL were followed up for examinations including PSA and transrectal sonography. Prostate biopsies were also recommended. Results Among the 1234 investigators, 146 cases were PSA> 4.0ng / ml, of which 126 cases were followed up and underwent transrectal ultrasound guided “10 point” prostate biopsy. Among the 101 cases of benign prostatic hyperplasia, PSA was (8.4 ± 14.2) ng / ml, PSA was significantly higher in the 25 patients with prostate cancer (29.3 ± 1 7.5) ng / ml, with significant difference between the two groups (P <0.05); 101 In patients with benign prostatic hyperplasia, the measured PV value was (32.61 ± 16.19) ml, while in 25 patients with prostate cancer, the PV value was (36.13 ± 12.73) ml, there was no significant difference between the two groups (P> 0.05 ). The relationship between different PSA concentrations and the incidence of prostate cancer was compared. The incidence of prostate cancer was significantly higher than that of 4ng / ml PSA <10ng / ml when PSA> 10ng / ml. Prostate cancer PSA value was significantly higher than the group of benign prostatic hyperplasia, prostate volume was no significant difference between the two groups. Conclusion PSA is an important tumor marker in the diagnosis of prostate cancer. Prostate “10-point” biopsy is an effective method to diagnose prostate cancer. Patients with PSA> 4.0ng / ml should be closely followed up and recommended transrectal prostate biopsy. Prostate cancer should be highly vigilant when the PSA is higher than 10ng / ml.