经尿道前列腺切除术后良性前列腺增生患者前列腺特异性抗原水平的变化

Jiao Liu, JiLei Tang, D. Gong, C. Kong
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引用次数: 4

摘要

目的:本研究旨在通过经尿道前列腺切除术(TURP)术后患者血清PSA的短期和长期变化,探讨前列腺特异性抗原(PSA)在经尿道前列腺切除术(TURP)手术前后的价值及其与切除程度的相关性。资料与方法:资料来源于209例前列腺增生症患者的回顾性抽样研究。术前及术后特定时间测定血清PSA水平;5天,1个月,3个月,6个月。这些时间与切除程度相关。结果:分别收集手术前后各时间段的PSA定量值。术后5天PSA值较术前下降约4.42±8.78 ng/mL,术后1个月PSA值下降35%。5个时间段的PSA水平差异有统计学意义(P < 0.01),且PSA >4 ng/mL组降低后仍高于PSA≤4 ng/mL组。TURP切除范围:实际切除质量与前列腺超声检查应切除质量的平均差值,以±标准差表示。总样品值为−0.941±9.56 ng/mL。PSA≤4 ng/mL组和PSA >4 ng/mL组分别为0.13±10.53和- 3.83±5.41。PSA变化与切除程度呈正相关(P < 0.01, R = 0.91)。此外,PSA≤4 ng/mL组和PSA >4 ng/mL组的PSA变化与切除程度呈正相关(P < 0.01, r1 = 0.986, r2 = 0.924)。结论:TURP术后PSA呈下降趋势。约1个月后PSA降至正常水平。有趣的是,更大的切除面积和PSA值的下降之间存在反比关系。因此,通过对前列腺增生患者TURP术后血清水平的长期随访,可以减少前列腺癌的漏诊和误诊。对于术前PSA >4 ng/mL的患者,在测量其前列腺穿刺活检结果和前列腺癌诊断时,应根据患者术后PSA基线采取监测标准。
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Level change of prostate-specific antigen in patients with benign prostatic hyperplasia after transurethral prostatic resection
Objectives: The objective of this study was to explore the values of prostate-specific antigen (PSA) before and after transurethral prostatic resection (TURP) surgery and the corresponding correlation with the resection extent through short and long-term changes of benign prostatic hyperplasia (BPH) of patient's serum PSA after TURP. Materials and Methods: Data were abstracted from a retrospective sampling study of 209 cases of BPH patients. The values of serum PSA level were measured preoperatively and at specified periods after TURP surgery; 5 days, 1 month, 3 months, and 6 months. These periods were correlated with the resection extent. Results: Quantitative PSA values were collected before and after the surgical procedure at the time periods. The decrease of PSA value was observed 5 days after surgery when compared with preoperative PSA value, which is about 4.42 ± 8.78 ng/mL while 35% decrease was reported following a month after surgery. Moreover, PSA levels in these five periods were significantly different (P < 0.01), and the value of PSA >4 ng/mL group is still higher than the group of PSA ≤4 ng/mL after the decrease. Resection extent of TURP: The mean differences between real removal quality and the quality, according to the prostate ultrasonography, should be removed, which is expressed in ± standard deviations. The value of the total sample is −0.941 ± 9.56 ng/mL. Values in the group of PSA ≤4 ng/mL and PSA >4 ng/mL are 0.13 ± 10.53 and −3.83 ± 5.41, respectively. There appears to be a positive correlation between the variations of PSA and the resection extent (P < 0.01, R = 0.91). In addition, a positive correlation was confirmed between the variations of PSA and the resection extent in the group of PSA ≤4 ng/mL and PSA >4 ng/mL (P < 0.01, R 1 = 0.986, R 2 = 0.924). Conclusion: A downward trend is demonstrated here in PSA after TURP. The PSA value lowered to a normal level in about 1 month. The interesting point is that there is an inverse relationship between the larger size of the resection and the decrease in PSA values. Thus, missed and misdiagnoses of prostate cancer could be reduced with the long-term follow-up of BPH patients' postoperative levels of serum after TURP. In regards to patients whose preoperative PSA >4 ng/mL, monitoring standards should be taken according to their postoperative PSA baseline when measuring their results of prostate needle biopsies and the diagnosis of prostatic cancer.
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