本文選題：前列腺癌 + 前列腺穿刺活檢術(shù)��； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討在PSA灰區(qū)(tPSA 4~10ng/ml)患者中,f/tPSA、PSAD和(f/t)PSA/PSAD值,以及增加穿刺針數(shù)和位點(diǎn)在前列腺癌診斷中的臨床價(jià)值。方法:回顧2008年1月至2016年3月我院接受TURS引導(dǎo)下前列腺穿刺的患者929例,對(duì)其中249例tPSA 4~10ng/ml患者的臨床資料進(jìn)行了整理分析。根據(jù)病理回報(bào)結(jié)果,分為前列腺癌組(PCa組)38例(15.26%),前列腺增生組(BPH組)211例(84.74%)。對(duì)患者年齡、tPSA、f/tPSA、PV、PSAD、(f/t)PSA/PSAD值做統(tǒng)計(jì)學(xué)分析。根據(jù)患者前列腺的穿刺針數(shù)和位點(diǎn)分組:A組,穿刺13針,共有病例218例;B組,穿刺13+n針,共有病例31例。比較兩組患者在不同穿刺針數(shù)下的穿刺陽(yáng)性率差異有無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)果:根據(jù)患者前列腺穿刺的針數(shù)和位點(diǎn)分組,A組218例中病理報(bào)告為癌的有27例,穿刺陽(yáng)性率12.39%;B組31例中病理報(bào)告為癌的有11例,穿刺陽(yáng)性率35.48%。根據(jù)χ~2檢驗(yàn),增加穿刺針數(shù)和位點(diǎn)后陽(yáng)性率增加有統(tǒng)計(jì)學(xué)意義(χ~2=9.48,P0.005)。兩組患者在年齡水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);在f/tPSA、PV、(f/t)PSA/PSAD水平,BPH組大于PCa組;在tPSA、PSAD水平,PCa組大于BPH組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。PCa組中f/tPSA或PSAD異常者32例,占84.21%;BPH組中f/tPSA或PSAD異常者110例,占52.13%,差異有統(tǒng)計(jì)學(xué)意義(χ~2=13.52,P0.005)。結(jié)論:對(duì)于PSA灰區(qū)(tPSA 4~10ng/ml)的患者,可能為早期患者腫瘤病灶較小,要果斷增加穿刺針數(shù)和位點(diǎn),以提高穿刺陽(yáng)性率。f/t PSA和PSAD異常對(duì)PSA灰區(qū)的患者是否行前列腺穿刺具有指導(dǎo)意義。如果f/t PSA和PSAD結(jié)果相矛盾,f/tPSA聯(lián)合PSAD、PSAD聯(lián)合(f/t)PSA/PSAD的診斷價(jià)值相對(duì)較高。
[Abstract]:Objective: to investigate the clinical value of fr / tPSAD and PSAD / PSAD in patients with 10 ng / ml TPSA in PSA gray region, and to evaluate the clinical value of increasing the number and locus of puncture needles in the diagnosis of prostate cancer. Methods: from January 2008 to March 2016, 929 cases of prostate puncture guided by TURS in our hospital were reviewed and the clinical data of 249 cases with tPSA 4~10ng/ml were analyzed. According to the pathological results, 38 cases were divided into PCA group (n = 38), BPH group (n = 211) and BPH group (n = 211). The age of patients with PSAD was analyzed statistically. According to the number and site of puncture needle of prostate, the patients were divided into two groups: group 1: group A: 13 needles, group B 218 cases, needle puncture 13 n, total cases 31 cases. To compare the positive rate of puncture between the two groups under different number of puncture needles. Results: according to the needle number and the site of prostate puncture, 27 cases of 218 cases in group A were pathologically reported as cancer, 11 cases of 31 cases in group B were diagnosed as cancer, and the positive rate of puncture was 35.48%. According to 蠂 ~ 2 test, there was statistical significance in increasing the number of puncture needles and the positive rate after the locus (蠂 ~ 2 + 9.48) (P 0.005). There was no significant difference in age level between the two groups (P 0.05); there was no significant difference between the two groups in age level (P 0.05); in the f / t PSAD group, the level of f/tPSA or PSAD was higher in BPH group than in PCa group; in BPH group, there were 32 cases of abnormal f/tPSA or PSAD in BPH group, accounting for 110 cases of f/tPSA or PSAD abnormality in 84.21 BPH group. The difference was statistically significant (蠂 2 + 13.52% P 0.005). Conclusion: for the patients with PSA gray area, it may be that the tumor focus is small in the early stage patients. It is necessary to increase the number of puncture needles and the number of puncture points so as to increase the positive rate of puncture. F- / t PSA and PSAD abnormality may be helpful for the patients with PSA gray area to perform prostate puncture or not. If the results of frt PSA and PSAD are inconsistent, the diagnostic value of frtPSA combined with PSAD combined with frtr / TSA / PSAD is relatively high.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.25

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