前列腺特异性抗原灰区在代谢综合征患者前列腺穿刺阳性率的临床意义

doi:10.19558/j.cnki.10-1020/r.2020.01.014

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摘要 目的：探讨代谢综合征（MS）患者在血清前列腺特异性抗原（PSA）灰区时前列腺癌穿刺阳性率与肿瘤的恶性程度的相关性。方法：回顾性分析1998年1月–2017年12月在北京医院泌尿外科进行前列腺穿刺活检术,且PSA为4~10 μg/L的650例患者的临床资料。根据2004年中华医学会糖尿病学分会制定的标准进行MS的诊断标准,分为MS组（400例）和非MS组（250例）,分析影响两组患者前列腺穿刺阳性率的因素及与MS与肿瘤恶性程度的相关性。结果：MS组确诊前列腺癌170例,前列腺穿刺阳性率42.50%（170/400）,其中低危前列腺癌8例（4.71%）,中危前列腺癌34例（20.00%）,高危前列腺癌128例（75.29%）;非MS组确诊前列腺癌42例,前列腺穿刺阳性率16.80%（42/250）,其中低危前列腺癌11例26.19%,中危前列腺癌14例（33.33%）,高危前列腺癌17例（40.47%）。MS组前列腺穿刺阳性率高于非MS组,差异有统计学意义（P<0.001）;MS组低危前列腺癌检出率小于非MS组（P<0.001）,中危前列腺癌检出率低于非MS组（P=0.098）,高危前列腺癌检出率高于非MS组（P<0.001）。Logistics回归分析提示年龄、BMI、血脂、前列腺体积是影响PAS为4~10 μg/L时前列腺穿刺阳性率的独立因素。结论：MS患者的前列腺穿刺阳性率高于非MS的患者,MS与前列腺癌的恶性程度和转移风险具有相关性,其中的因果关系需要进一步验证。

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	付春龙
	张亚群
	侯惠民
	朱生才
	郭博达
	王鑫
	宋新达
	陈佳
	程万里
	王建业
	刘明

关键词 ：前列腺特异性抗原, 前列腺穿刺, 代谢综合征, 前列腺癌

Abstract：Objective： To investigate the correlation between the positive rate of prostate puncture biopsy and the malignant degree of tumor in patients with metabolic syndrome (MS) in PSA grey zone. Methods： 650 patients with PSA in 4~10 μg/L underunderwent prostate biopsy in the Department of Urology,Beijing Hospital from January 1998 to December 2017, the clinical data of patients were analyzed retrospectively. The patients were divided into MS group (n=400) and non-MS group (n=250). The influencing factors of positive prostate biopsy and the correlation analysis with tumor malignancy were analyzed. Results： In MS group, 170 cases were diagnosed as prostate cancer, the positive rate of prostate puncture was 42.5% (170/400).There were 8（4.71%） low-risk cases, 34 (20.00%) medium-risk cases and 128 (75.29%) high-risk cases. 42 cases were diagnosed prostate cancer in non MS group, the positive rate of prostate puncture was 16.80% (42/250). There were 11 (26.19%) low-risk cases, 14 (33.33%) medium-risk cases and 17 (40.47%) high-risk cases. The positive rate of puncturing prostate in MS group was higher than that of non MS group (P < 0.001); the detection rate of low-risk prostate cancer in MS group was lower than that of non MS group (P < 0.001); the detection rate of medium-risk prostate cancer was lower than that of non MS group (P = 0.098); the detection rate of high-risk prostate cancer in MS group was higher than that of non MS group (P < 0.001).Logistics regression analysis indicated age, BMI, hyperlipemia and prostate volume were independent factors affected the positive rate of prostate biopsy in PSA 4~10 μg/L. Conclusion： The positive rate of prostate biopsy in MS patients is higher than that of non-MS patients. MS can increase the malignant degree and risk of metastasis of prostate cancer.

Key words： prostate specific antigen prostate puncture biopsy metabolic syndrome prostate cancer

收稿日期: 2019-09-30

ZTFLH:

R737.25

基金资助:北京医院211工程基金（NO. BJ-2018-090）

通讯作者: 刘明,liuming19731029@163.com

引用本文:

付春龙, 张亚群, 侯惠民, 朱生才, 郭博达, 王鑫, 宋新达, 陈佳, 程万里, 王建业, 刘明. 前列腺特异性抗原灰区在代谢综合征患者前列腺穿刺阳性率的临床意义[J]. 微创泌尿外科杂志, 2020, 9(1): 65-69.
FU Chunlong, ZHANG Yaqun, HOU Huiming, ZHU Shengcai, GUO Boda, WANG Xin, SONG Xinda, CHEN Jia, CHENG Wanli, WANG Jianye, LIU Ming. Correlation of metabolic syndrome with positive rate of prostate biopsy in patients in PSA grey zone. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(1): 65-69.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1570.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I1/65

[1] DE NUNZIO C, BRASSETTI A, SIMONE G, et al.Metabolic syndrome increases the risk of upgrading and upstaging in patients with prostate cancer on biopsy: a radical prostatectomy multicenter cohort study. Prostate Cancer Prostatic Dis,2018,21(3):438-445.
[2] 项坤三,纪立农,向红丁,等.中华医学会糖尿病学分会关于代谢综合征的建议.中国糖尿病杂志,2004,12(3):156-161.
[3] 韩苏军,张思维,陈万青,等.中国前列腺癌死亡现状及流行趋势分析.中华泌尿外科杂志,2012,33(11):836-839.
[4] HABCHI H, MOTTET N.Management of Prostate Cancer: EAU Guidelines on Screening, Diagnosis and Local Primary Treatment//Management of prostate cancer: A multidisciplinary approach. NY: Springer,2017:399-411.
[5] 中华医学会泌尿外科学分会.中国前列腺癌联盟.前列腺穿刺中国专家共识.中华泌尿外科杂志,2016,37(4):241-244.
[6] 刘和谦,于德新,张志强,等.代谢综合征与前列腺穿刺阳性率的相关性分析.中国男科学杂志,2013,27(12):21-25.
[7] ESPOSITO K, CHIODINI P, COLAO A, et al.Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care, 2012,35(11):2402-2411.
[8] 陈思阳,杜源.代谢综合征与前列腺癌危险性的相关性分析.国际外科学杂志,2018,45(7):456-460.
[9] CICIONE A, DE NUNZIO C, TUBARO A, et al.Metabolic syndrome diagnosis and widespread high grade prostatic intraepithelial neoplasia significantly increase prostate cancer risk: results from a multicenter biopsy study. BMC Cancer, 2016,16(1):59.
[10] DE NUNZIO C, SIMONE G, BRASSETTI A, et al.Metabolic syndrome is associated with advanced prostate cancer in patients treated with radical retropubic prostatectomy: results from a multicentre prospective study. BMC Cancer, 2016,16(1):407.
[11] TANDE AJ, PLATZ EA, FOLSOM AR.The metabolic syndrome is associated with reduced risk of prostate cancer. Am J Epidemiol, 2006,164(11):1094-1102.
[12] 袁效良,张桂铭,孙立江.代谢综合征与3种常见泌尿男生殖系统肿瘤关系的研究进展.齐鲁医学杂志,2017,32(5):624-627,630.
[13] WALLNER LP, MORGENSTERN H, MICHAELA EM, et al.The effects of metabolic conditions on prostate cancer incidence over 15 years of follow-up: results from the Olmsted County Study. BJU Int, 2011,107(6):929-935.
[14] 罗旭. 代谢综合征的干预在前列腺癌患者治疗中的临床意义.国际泌尿系统杂志,2018,38(3):486-490.
[15] GACCI M, RUSSO GI, DE NUNZIO C, et al.Meta-analysis of metabolic syndrome and prostate cancer. Prostate Cancer Prostatic Dis, 2017,20(2):146-155.
[16] SHIOTA M, YOKOMIZO A, TAKEUCHI A, et al.The feature of metabolic syndrome is a risk factor for biochemical recurrence after radical prostatectomy. J Surg Oncol, 2014,110(4):476-481.
[17] BHINDI B, XIE WY, KULKARNI GS, et al.Influence of metabolic syndrome on prostate cancer stage, grade, and overall recurrence risk in men undergoing radical prostatectomy. Urology, 2016,93: 77-85.
[18] ZHANG GM, ZHU Y, DONG DH, et al.The association between metabolic syndrome and advanced prostate cancer in Chinese patients receiving radical prostatectomy. Asian J Androl, 2015,17(5):839-844.
[19] 孙明冲,徐奔.代谢综合征对前列腺癌术后生化复发的影响:一项竞争风险分析.现代泌尿外科杂志,2018,23(12):943-947.
[20] METALLI D, LOVAT F, TRIPODI F, et al.The insulin-like growth factor receptor I promotes motility and invasion of bladder cancer cells through Akt- and mitogen-activated protein kinase-dependent activation of paxillin. Am J Pathol, 2010,176(6):2997-3006.
[21] DANDONA P, ALJADA A, CHAUDHURI A, et al.Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation, 2005,111(11):1448-1454.
[22] BLANDO J, SAHA A, KIGUCHI K, et al.Obesity, Inflammation, and Prostate Cancer. NY: Springer, 2013:201.
[23] 胡梦博. 代谢综合征(MS)与前列腺癌:分子机制及治疗方法研究进展.复旦学报(医学版),2014,41(6):830-834.
[24] GUO J, WANG M, LIU X.MicroRNA-195 suppresses tumor cell proliferation and metastasis by directly targeting BCOX1 in prostate carcinoma. J Exp Clin Cancer Res, 2015,34(1):91.
[25] ZUREIK M, COURBON D, DUCIMETIÈRE P. Decline in serum total cholesterol and the risk of death from cancer. Epidemiology, 1997,8(2):137-143.
[26] LONG XJ, LIN S, SUN YN, et al.Diabetes mellitus and prostate cancer risk in Asian countries: a meta-analysis. Asian Pac J Cancer Prev, 2012,13(8):4097-4100.
[27] 黄中华,王忠康,周兴.代谢综合征与非肌层浸润性膀胱癌关系的研究进展.国际泌尿系统杂志,2019,39(2):323-325.
[28] MONTELLA M, DI MASO M, CRISPO A, et al.Metabolic syndrome and the risk of urothelial carcinoma of the bladder: a case-control study. BMC Cancer, 2015,15(1):720.