尿液中PCA3 mRNA和融合基因TMPRSS2:ERG mRNA的检测在前列腺癌早期临床诊断中的应用  

Quantitative Detection of PCA3 mRNA and T1E4 mRNA-the Isoform of Fusion Gene TMPRSS2:ERG in Urine of Patients for the Early Clinical Diagnosis of Prostate Cancer

作　　者：戴美洁[1] 孔凡慧[1] 沈默[1] 周武[1] 陈伟[2] 吴秀玲[3] 翁志梁[2] 陶志华[1] 

机构地区：[1]浙江温州医学院附属第一医院检验科,325000 [2]浙江温州医学院附属第一医院泌尿外科,325000 [3]浙江温州医学院附属第一医院病理科,325000

出　　处：《医学研究杂志》2011年第9期20-24,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(30872421);浙江省医药卫生科学研究基金计划(2008A119)

摘　　要：目的研究前列腺按摩后尿液中PCA3 mRNA联合融合基因TMPRSS2:ERG亚型T1E4 mRNA的定量检测在早期前列腺癌临床诊断中的应用价值。方法收集前列腺癌(PCa)患者53例和前列腺增生(BPH)患者37例,收集前列腺按摩后尿液,离心取细胞沉淀物,提取总RNA,用实时荧光定量RT-PCR的方法检测PSA mRNA、PCA3 mRNA和T1E4 mRNA的含量,以PSA mRNA来校正尿液中的前列腺癌细胞。以PCA3 mRNA/PSA mRNA表示PCA3 mRNA的含量,以T1E4 mRNA/PSA mRNA表示融合基因T1E4 mRNA的含量。用ROC曲线对T1E4 mRNA及PCA3 mRNA诊断PCa的性能进行分析。结果尿T1E4 mR-NA/PSA mRNA比值诊断PCa的ROC曲线下面积(AUC)为0.802(95%CI:0.709～0.895),以0.007为截断值时,其诊断前列腺癌的敏感度和特异度分别为56.6%和94.6%。尿PCA3 mRNA/PSA mRNA比值诊断PCa的ROC曲线下面积(AUC)为0.646(95%CI:0.533～0.758),以0.001为截断值时,其诊断前列腺癌的敏感度和特异度为47.2%和73.0%。PCa组PCA3 mRNA(P=0.009)及T1E4 mRNA(P=0.000)的含量均高于BPH组,T1E4 mRNA联合PCA3 mRNA定量检测的敏感度为81.1%,比单独应用PCA3 mRNA和T1E4 mRNA检测的敏感度分别提高了33.9%和24.5%。结论前列腺癌按摩后尿沉渣中可以检测到TMPRSS2:ERG亚型T1E4 mRNA,联合PCA3 mRNA和T1E4 mRNA两个指标定量检测,可以显著提高检出前列腺癌的敏感度。此联合检测方法可以用于早期的前列腺癌诊断。Objective To investigate the utility of the quantitative detection of PCA3 mRNA and T1E4 mRNA（the isoform of TM- PRSS2 ： ERG fusion gene） in urine after prostate massage for the diagnosis of prostate cancer. Methods T1 E4 mRNA,PCA3 mRNA and PSA mRNA were measured by real - time fluorescent quantitative reverse transcription polymerase chain reaction （ FQ - RT - PCR） based on taqman technique in urine samples of 53 PCa and 37 BPH patients after prostate massage. PSA mRNA was used to normalize the num- ber of prostate cells and T1 E4 mRNA/PSA mRNA ratio was then used as a diagnostic marker for prostate cancer. The diagnostic efficacies of T1E4 mRNA and PCA3 mRNA in urine samples were evaluated by the ROC curve. Then the diagnostic efficacies of detection of PCA3 mRNA and T1 E4 mRNA were analyzed. Results AUC of T1 E4 mRNA/PSA mRNA ratio was 0. 802 （95 % C1：0. 709 - O. 895 ）. The diag- nostic sensitivity and specificity of T1 E4 mRNA/PSA mRNA ratio were 56.6% and 94.6% at a cut off of 0. 007. AUC of PCA3 mRNA/ PSA mRNA ratio was 0. 646（95% C1：0. 533 -0. 758 ）. The diagnostic sensitivity and specificity of T1E4 mRNA/PSA mRNA ratio were 47.2% and 73.0% at a cut off of 0. 001. The T1E4 mRNA expression in PCa group was significantly higher than that in the BPH group （ P = 0. 000）. The PCA3 mRNA expression in PCa group was significantly higher than that in the BPH group （ P = O. 009）. The combina- tion of both markers remarkably increased the sensitivity from 47.2% （ PCA3 test alone） and 56.6% （ TIE4 test alone） to 81. 1%. The diagnostic efficacies increased by 33.9% and 24.5% ,respectively. Conclusion T1E4 mRNA can be detected in the urine of the prostate cancer patients. The two makers can improve the diagnosis prostates cancer and may potentially be used in the early diagnosis of prostate

关 键 词：前列腺癌 融合基因 TMPRSS2基因 PCA3基因 尿液 肿瘤标志物 

分 类 号：R512.91[医药卫生—内科学]