前列腺穿刺活检中高敏C反应蛋白对穿刺阳性率的影响
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摘要
目的探讨前列腺活检患者血清高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)对前列腺穿刺阳性率的影响。方法选取2013年5月至2017年5月住院的行前列腺穿刺活检的230例患者作为研究对象,经病理确诊为前列腺癌(prostatic cancer,PCa)患者80例,良性前列腺增生(benign prostatic hyperplasia,BPH)患者150例。采用多元Logistic回归分析hs-CRP等因素对前列腺穿刺阳性率的影响。结果 (1) PCa患者hs-CRP水平明显高于BPH患者(P<0. 05);(2) hs-CRP>3 mg/L者76例,其中PCa患者42例,穿刺阳性率为55. 26%(42/76); hsCRP≤3 mg/L者154例,其中PCa患者38例,穿刺阳性率为24. 68%(38/154)。hs-CRP> 3 mg/L者前列腺穿刺阳性率明显高于hs-CRP≤3 mg/L者(P<0. 05);(3)经多元Logistic回归分析,hs-CRP是影响前列腺穿刺阳性率的独立危险因素。结论 hs-CRP是影响前列腺穿刺阳性率的一个独立危险因素,当血清之中的该指标水平上升时,前列腺穿刺阳性率随之而显著升高,对于疾病的临床诊断具有提示意义。
Objective To investigate the effects of serum high-sensitivity C-reactive protein( hs-CRP) value on positive rate of prostate puncture in patients with prostate biopsy. Methods In this study,we selected 230 patients who underwent prostate biopsy in our hospital from May 2013 to May 2017 as subjects,and 150 patients with benign prostatic hyperplasia( BPH) were diagnosed as prostate cancer( PCa) in 80 cases. The effects of hs-CRP and other factors on the positive rate of prostate puncture were analyzed by multivariate logistic regression. Results( 1) The hs-CRP level of PCA patients was significantly higher than that in BPH patients( P <0. 05).( 2) In 76 cases of hs-CRP >3 mg/L,the number of PCA was 42 cases,and the positive rate of puncture was 55. 26%( 42/76). In 154 cases,the number of PCA patients was 38 cases,and the positive rate of puncture was 24. 68%( 38/154) hs-CRP≤3 mg/L. The positive rate of prostate puncture in hs-CRP > 3 mg/L was significantly higher than that of hs-CRP≤3mg/L( P < 0. 05).( 3) By multivariate logistic regression analysis,hs-CRP is an independent risk factor affecting the positive rate of prostate puncture. Conclusion hs-CRP is an independent risk factor affecting the positive rate of prostate puncture,the positive rate of prostate puncture increases significantly when the level of serum is increased,which has significance in the clinical diagnosis of the disease.
Objective To investigate the effects of serum high-sensitivity C-reactive protein( hs-CRP) value on positive rate of prostate puncture in patients with prostate biopsy. Methods In this study,we selected 230 patients who underwent prostate biopsy in our hospital from May 2013 to May 2017 as subjects,and 150 patients with benign prostatic hyperplasia( BPH) were diagnosed as prostate cancer( PCa) in 80 cases. The effects of hs-CRP and other factors on the positive rate of prostate puncture were analyzed by multivariate logistic regression. Results( 1) The hs-CRP level of PCA patients was significantly higher than that in BPH patients( P <0. 05).( 2) In 76 cases of hs-CRP >3 mg/L,the number of PCA was 42 cases,and the positive rate of puncture was 55. 26%( 42/76). In 154 cases,the number of PCA patients was 38 cases,and the positive rate of puncture was 24. 68%( 38/154) hs-CRP≤3 mg/L. The positive rate of prostate puncture in hs-CRP > 3 mg/L was significantly higher than that of hs-CRP≤3mg/L( P < 0. 05).( 3) By multivariate logistic regression analysis,hs-CRP is an independent risk factor affecting the positive rate of prostate puncture. Conclusion hs-CRP is an independent risk factor affecting the positive rate of prostate puncture,the positive rate of prostate puncture increases significantly when the level of serum is increased,which has significance in the clinical diagnosis of the disease.
引文
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[8]刘龙亚,温端改,何军,等.外周血与尿PCA3基因表达和尿PCA3评分在前列腺癌诊断中的意义[J].中华泌尿外科杂志,2012,33(4):278-281.DOI:10.3760/cma.j.issn.1000-6702 2012.04.012.
[9]李鸣,张思维,马建辉,等.中国部分市县前列腺癌发病趋势比较研究[J].中华泌尿外科杂志,2009,30(6):368-370.DOI:10.3760/cma.j.issn.1000-6702.2009.06.003.
[10]姚明华,郭乐航,王帅,等.超声引导下经会阴部前列腺穿刺活组织检查术在前列腺癌诊断中的意义[J].上海医学,2012,35(5):400-402.
[11]李平法,秦双,张忠新,等.血清C-反应蛋白水平与激素难治性前列腺癌患者预后的相关性[J].中国老年学杂志,2013,33(6):1289-1290.DOI:10.3969/j.issn.1005-9202.2012.06.026.
[12]何安仁,刘桂勇,万齐福,等.前列腺液Zn及CRP检测在慢性前列腺炎患者诊治中的价值[J].中华全科医学,2013,11(11):1718-1719.
[13]SFANOS K S,DE MARZO A.Prostate cancer and inflammation:the evidence[J].Histopathology,2012,60:199-215.
[14]陈松,王行环,熊涵楚,等.前列腺穿刺活检患者中血清高敏C反应蛋白测定的临床意义[J].中国性科学,2015,24(8):8-10.DOI:10.3969/j.issn.1672-1993.2015.08.003.
[15]莫晓东,蔡晓峰,李纲,等.前列腺穿刺活检患者中血清高敏C反应蛋白测定的临床意义[J].中华泌尿外科杂志,2014,35(6):461-464.DOI:10.3760/cma.j.issn.1000-6702.2014.06.017.
[16]褚靖,谢群,杨信,等.不同PSA相关肿瘤标志物在前列腺癌中的诊断价值[J].实用医学杂志,2014,9(13):2123-2125.DOI:10.3969/j.issn.1006-5725.2014.13.036.
[2]陈超,谢立平,郑祥毅,等.前列腺特异性抗原密度预测首次前列腺活检标本Gleason评分升高的价值[J].中华泌尿外科杂志,2013,34(10):755-759.DOI:10.3760/cma.J.issn.1000-6702.2013.10.010.
[3]MANTOVANI A.Molecular pathways linking inflammation and cancer[J].Curt Mol Med,2010,10(4):369-373.
[4]郑清水,李晓东,许宁,等.前列腺特异性抗原升高首次活检阴性行重复穿刺患者阳性预测因素研究[J].中华实验外科杂志,2014,31(8):1834-1836.DOI:10.3760/cma.j.issn.1001-9030.2014.08.079.
[5]冀景刚,刘海勇,孙立巍,等.血浆β2-微球蛋白、H-CRP、HCY与外周动脉粥样硬化病的风险分级关系[J].医学研究与教育,2015,32(2):40-43.DOI:10.3969/j.issn.1674-490X.2015.02.009.
[6]周莉,骆永伟,王永,等.雌激素诱导SD大鼠前列腺炎与内环境改变的关系[J].中国比较医学杂志,2014,24(2):33-37.DOI:10.3969.j.issn.1671.7856.2014.002.008.
[7]刘明,王建业,万钢,等.1995-2008年北京医院前列腺癌诊断状况变迁[J].中华泌尿外科杂志,2011,32(8):535-538.DOI:l0.3760/cma.j.jssn.10.6702.2011.08.011.
[8]刘龙亚,温端改,何军,等.外周血与尿PCA3基因表达和尿PCA3评分在前列腺癌诊断中的意义[J].中华泌尿外科杂志,2012,33(4):278-281.DOI:10.3760/cma.j.issn.1000-6702 2012.04.012.
[9]李鸣,张思维,马建辉,等.中国部分市县前列腺癌发病趋势比较研究[J].中华泌尿外科杂志,2009,30(6):368-370.DOI:10.3760/cma.j.issn.1000-6702.2009.06.003.
[10]姚明华,郭乐航,王帅,等.超声引导下经会阴部前列腺穿刺活组织检查术在前列腺癌诊断中的意义[J].上海医学,2012,35(5):400-402.
[11]李平法,秦双,张忠新,等.血清C-反应蛋白水平与激素难治性前列腺癌患者预后的相关性[J].中国老年学杂志,2013,33(6):1289-1290.DOI:10.3969/j.issn.1005-9202.2012.06.026.
[12]何安仁,刘桂勇,万齐福,等.前列腺液Zn及CRP检测在慢性前列腺炎患者诊治中的价值[J].中华全科医学,2013,11(11):1718-1719.
[13]SFANOS K S,DE MARZO A.Prostate cancer and inflammation:the evidence[J].Histopathology,2012,60:199-215.
[14]陈松,王行环,熊涵楚,等.前列腺穿刺活检患者中血清高敏C反应蛋白测定的临床意义[J].中国性科学,2015,24(8):8-10.DOI:10.3969/j.issn.1672-1993.2015.08.003.
[15]莫晓东,蔡晓峰,李纲,等.前列腺穿刺活检患者中血清高敏C反应蛋白测定的临床意义[J].中华泌尿外科杂志,2014,35(6):461-464.DOI:10.3760/cma.j.issn.1000-6702.2014.06.017.
[16]褚靖,谢群,杨信,等.不同PSA相关肿瘤标志物在前列腺癌中的诊断价值[J].实用医学杂志,2014,9(13):2123-2125.DOI:10.3969/j.issn.1006-5725.2014.13.036.