血清PSA、EGF在不同类型良性前列腺增生患者中表达意义及其与术后疾病转归的相关性分析

摘要 目的：分析血清前列腺特异抗原（PSA)、表皮生长因子（EGF)在不同类型良性前列腺增生患者中低表达意义及其与术后疾病转归的相关性。方法：选择自2020年1月至2022年12月在我院接受手术治疗的128例良性前列腺增生患者作为研究对象，根据术后病理活检结果进行分组，间质结节组（16例）、腺肌性结节组（32例）、纤维腺瘤性结节组（12例）、腺性结节组（30例）和混合结节组（38例），其中以间质增生为主60例、以腺体增生为主68例。检测所有患者血清PSA、EGF的表达水平，以术后6个月的国际前列腺症状评分（IPSS评分）<8分判定为预后良好，分析血清PSA、EGF在预后良好组与预后不良组之间的差异性及与IPSS评分的关系。结果：血清PSA、EGF表达水平在间质结节组、腺肌性结节组、纤维腺瘤性结节组、腺性结节组和混合结节组间比较有差异（P<0.05）；以腺体增生为主的良性前列腺增生患者血清PSA、EGF表达水平均明显高于以间质增生为主的患者（P<0.05）；经ROC曲线分析，血清PSA联合EGF预测以腺体增生为主的良性前列腺增生的敏感度为86.42%，特异度为65.34%，AUC为0.930；所有患者均获得随访6个月，预后良好98例、预后不良30例；预后不良组血清PSA、EGF表达水平均明显高于预后良好组（P<0.05）；经Pearson相关性分析，良性前列腺增生患者血清PSA、EGF表达水平均与IPSS评分呈负相关（r值分别为-0.348、-0.417，P值均为0.000）。结论：血清PSA、EGF在不同病理类型良性前列腺增生患者中表达差异显著，以间质增生为主的患者，以腺体增生为主的患者血清PSA、EGF表达水平更高，两者均与术后疾病转归密切相关，值得临床予以重视。

The Expression Significance of Serum PSA and EGF in Patients with Different Types of Benign Prostatic Hyperplasia and Their Correlation with Postoperative Disease Outcome

ABSTRACT Objective: To analyze the significance of low expression of serum prostate-specific antigen (PSA) and epidermal growth factor (EGF) in patients with different types of benign prostatic hyperplasia (BPH) and their correlation with postoperative disease outcomes. Methods: 128 patients with benign prostatic hyperplasia who received surgical treatment in our hospital from January 2020 to December 2022 were selected as the study objects and grouped according to postoperative pathological biopsy results. Interstitial nodule group (16 cases), adenomuscular nodule group (32 cases), fibladenomatous nodule group (12 cases), glandular nodule group (30 cases) and mixed nodule group (38 cases), of which 60 cases had interstitial hyperplasia and 68 cases had glandular hyperplasia. The expression levels of serum PSA and EGF in all patients were detected,and the International Prostate Symptom score (IPSS)<8 six months after surgery was used to determine the prognosis. The difference between serum PSA and EGF in the good prognosis group and the poor prognosis group and the relationship with IPSS score were analyzed. Results: There were differences in serum PSA and EGF expression levels among interstitial nodule group, adenomuscular nodule group, fibladenoma nodule group, glandular nodule group and mixed nodule group (P<0.05). The serum levels of PSA and EGF in BPH patients with glandular hyperplasia were significantly higher than those in BPH patients with interstitial hyperplasia (P<0.05). ROC curve analysis showed that serum PSA combined with EGF had a sensitivity of 86.42%, specificity of 65.34% and AUC of 0.930 in predicting benign prostatic hyperplasia (BPH). All patients were followed up for 6 months, with good prognosis in 98 cases and bad prognosis in 30 cases.The expression levels of serum PSA and EGF in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05). According to Pearson correlation analysis, serum PSA and EGF expression levels in BPH patients were negatively correlated with IPSS score (r value was -0.348, -0.417, P value was 0.000). Conclusion: Serum PSA and EGF are significantly different in patients with different pathologic types of BPH, and the serum PSA and EGF are higher in patients with mainly interstitial hyperplasia and mainly glandular hyperplasia, both of which are closely related to postoperative disease outcomes and deserve clinical attention.