中医体质辨识在前列腺特异性抗原“灰区”前列腺癌早期诊断中的应用
作者：王 岩1,2，郭冬冬1,2，马 骋1,2，占向阳1,2，琚官群1,2，徐东亮1,2
单位：1.上海中医药大学附属曙光医院，上海 201203； 2.上海市中医临床重点实验室，上海 201203
引用：引用：王岩，郭冬冬，马骋，占向阳，琚官群，徐东亮.中医体质辨识在前列腺特异性抗原“灰区”前列腺癌早期诊断中的应用[J].中医药导报,2026,32(5):95-98.
DOI：10.13862/j.cn43-1446/r.2026.05.015
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摘要：目的：探讨中医体质辨识在前列腺特异性抗原（PSA）“灰区”前列腺癌早期诊断中的临床应用价值。方法：纳入136例初诊PSA“灰区”患者的相关资料，采用多重线性回归模型分析不同穿刺病理与中医体质类型、PSA水平、年龄的相关性。结果：前列腺癌患者与良性前列腺增生患者在湿热质和痰湿质的体质分布上存在差异。逻辑回归分析结果显示，痰湿质和气虚质可能是前列腺癌的易感体质，而湿热质可能是良性前列腺增生的易感体质。结合中医体质辨识、年龄和PSA数据的诊断模型曲线下面积（AUC）为0.826，显著高于仅使用PSA+年龄或仅使用中医体质辨识的模型。结论：中医体质辨识可能有助于提高PSA“灰区”患者的早期诊断效能。
关键词：前列腺癌；中医体质；前列腺特异性抗原；早期诊断
Abstract：Objective: To explore the clinical value of traditional Chinese medicine (TCM) constitutional identification in the early diagnosis of prostate cancer among patients with prostate-specific antigen (PSA) "grey zone". Methods: Data from 136 patients with initial diagnosis of PSA in the "grey zone" were collected. Multiple linear regression analysis was used to analyze the correlations between different puncture pathologies and TCM constitution types, PSA levels, and age. Results: There were significant differences in the distribution of damp-heat constitution and phlegm-damp constitution between prostate cancer patients and benign prostatic hyperplasia patients. Logistic regression analysis showed that phlegm-damp constitution and qi-deficiency constitution were potential predisposing constitutions for prostate cancer, while damp-heat constitution was a predisposing constitution for benign prostatic hyperplasia. The area under the curve (AUC) of the diagnostic model combining TCM constitutional types, age and PSA was 0.826, significantly higher than that of models using PSA plus age or TCM constitutional identification alone. Conclusion: TCM constitutional identification can effectively improve the early diagnostic performance for patients with PSA "grey zone".
Key words：prostate cancer; traditional Chinese medicine constitution identification; prostate-specific antigen; early diagnosis
发布时间：2026-05-23
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