本文選題：PSA　切入點(diǎn)：F/T比值　出處：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討PSA、F/T比值以及PSAD分別在前列腺癌的確定診斷中的價(jià)值。 方法：本研究選取2005年7月至2012年8月經(jīng)過前列腺穿刺活檢和/或手術(shù)標(biāo)本病理確診的前列腺疾病患者共208例，分為前列腺癌組（惡性組）和良性前列腺增生組（良性組）；根據(jù)經(jīng)直腸超聲的結(jié)果分為有結(jié)節(jié)（陽(yáng)性）組和無(wú)結(jié)節(jié)（陰性）組；根據(jù)結(jié)節(jié)回聲特性分為低回聲組和高（混合）回聲組；檢測(cè)血清中總PSA以及游離PSA、并計(jì)算F/T比值，TRUS測(cè)量前列腺的體積并計(jì)算PSAD值，，根據(jù)PSA（ng/ml）水平分為5組，PSA＜4、4≤PSA＜10、10≤PSA＜20、20≤PSA＜30和PSA≥30組，PSA（ng/ml）分別取4、10、20、30為臨界值，F(xiàn)/T比值取0.16、0.18、0.20為臨界值，PSAD（ng/ml/cm3）取0.15、0.25、0.35為臨界值，比較各指標(biāo)在不同臨界值時(shí)預(yù)測(cè)前列腺癌的敏感度、特異度以及約登指數(shù)，探討能夠?qū)η傲邢侔┐_定診斷的最合適各項(xiàng)指標(biāo)值。 結(jié)果：前列腺癌患者的PSA值、PSAD值及低回聲結(jié)節(jié)出現(xiàn)的比例均明顯高于良性前列腺增生組（P值均＜0.01）；PSA（ng/ml）分別取4、10、20、30為臨界值時(shí)預(yù)測(cè)前列腺癌的敏感度分別為94.03%、84.33%、67.16%、56.72%，特異度分別為31.08%、78.38%、93.24%、97.30%，約登指數(shù)分別為0.2571、0.6271、0.604和0.5402；F/T比值取0.16、0.18、0.20為臨界值時(shí)預(yù)測(cè)前列腺癌的敏感度分別為71.64%、73.88%和76.87%，特異度分別為67.57%、64.86%和58.11%，約登指數(shù)分別為0.3921、0.3874和0.3498；PSAD（ng/ml/cm3）取0.15、0.25、0.35為臨界值時(shí)預(yù)測(cè)前列腺癌的敏感度分別為88.81%、80.60%和73.88%，特異度分別為68.92%、87.84%和95.95%，約登指數(shù)分別為0.5733、0.6844和0.6983。 結(jié)論：在本研究中PSA值分別取10ng/ml、F/T值取0.16、PSAD值取0.35ng/ml/cm3時(shí)對(duì)前列腺癌的診斷具有較高的敏感度、特異度及約登指數(shù)。
[Abstract]:Objective: to evaluate the value of PSAD and PSAD in the diagnosis of prostate cancer.Methods: from July 2005 to August 2012, 208 patients with prostate diseases diagnosed by biopsy and / or operation were selected.They were divided into prostate cancer group (malignant group) and benign prostatic hyperplasia group (benign group), according to the results of transrectal ultrasound, they were divided into nodule group (positive group) and non-nodular group (negative group).The nodules were divided into low echo group and high echo group according to their echo characteristics. The total PSA and free PSAs in serum were measured, and the volume of prostate was measured and PSAD was calculated by F- / T ratio TRUS.Specificity and Yorden index to determine the most appropriate diagnostic criteria for prostate cancer.The sensitivity was 88.81% and 73.88%, the specificity was 68.92% and 95.95%, respectively, and the Yorden index was 0.5733 ~ 0.6844 and 0.6983, respectively.Conclusion: in this study, the sensitivity, specificity and Jordan index of diagnosis of prostate cancer were higher when the PSA value was 10 ng / ml / L F- / T value and 0.16% PSAD value was taken for the diagnosis of prostate cancer.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.25

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本文編號(hào)：1730124