联合检测血清HMGB1 PSA在局限性前列腺癌冷冻术后复发中的应用价值  

Significance of combined detection of serum HMGB1 and prostate-specific antigen in predicting the recurrence of local prostate cancer

作　　者：胡萍[1] 司同国[1] 于海鹏[1] 王海涛[1] 郭志[1] 

机构地区：[1]天津医科大学附属肿瘤医院介入科.天津市肿瘤防治重点实验室,天津市300060

出　　处：《中国肿瘤临床》2013年第8期462-465,共4页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金(编号:30973438,81001002);天津市应用基础及前沿技术研究计划(编号:09JCYBJC10400)资助~~

摘　　要：目的:探讨局限性前列腺癌经前列腺癌氩氦冷冻治疗后血清HMGB1和PSA表达在预测治疗后复发中的临床价值。方法:应用酶联免疫吸附试验(ELISA)测定80例局限性前列腺癌患者(Pca组)冷冻治疗前、后和30例前列腺良性增生患者(BPH组)、20例健康对照者血清HMGB1和PSA表达。Pca组术后PSA、MRI随访,经病理穿刺活检证实:局部复发9例,远处转移3例。比较Pca组术后血清HMGB1表达,及预测前列腺癌复发的价值。结果:Pca组术前血清HMGB1(94.0±77.4 ng/mL)相比BPH组(33.2±7.4 ng/mL)和健康对照组(24.7±7.3 ng/mL)显著升高(P<0.001)。Pca组术后血清HMGB1(55.0±11.0 ng/mL)较术前显著降低(P=0.005);Pca组冷冻治疗后,复发者术后HMGB1平均值为(70.8±2.7)ng/mL,无复发者术后HMGB1平均值为(55.0±10.8)ng/mL,差异有统计学意义(P=0.001);3例远处转移患者血清HMGB1水平较9例局部复发者显著升高(94.2±17.9 vs.73.1±7.9ng/mL)。术后血清HMGB1相比PSA预测复发性Pca的敏感性高(83.3%Vs.66.7%),而两者联合诊断的特异性较单一PSA高(95.6%vs.82.4%)。Pca组术后HMGB1表达与临床分期、复发和转移(P<0.001)相关,与Gleason评分无显著相关性(P>0.05)。结论:血清HMGB1在Pca中高表达,提示血清HMGB1可作为一项预测和预后指标。此外,Pca患者冷冻治疗后联合检测HMGB1和PSA对于复发患者可提高早期诊断率,有效的指导病理穿刺活检及后续治疗。Objective： This study aimed to investigate the expression of serum HMGB 1 and prostate-specific antigen （PSA） in di- agnosing the recurrence of localized prostate cancer （Pca） in patients who had undergone cryotherapy treatment. Methods： En- zyme-linked immunosorbent assay （ELISA） was performed to measure the serum HMGB1 levels of 80 prostate cancer patients pre- and post-operation, as well as the PSA levels in 30 benign prostatic hyperplasia （BPH） and 20 healthy subjects. During follow-up, PSA anal- ysis, MRI, and pathology biopsy confirmed nine cases of local recurrence and three cases of metastasis. The post-operative serum HMGB1 expression and its diagnosis value in Pca recurrence were also determined. Results： First, the HMGBlexpression level in Pca （94.0 ± 77.4 ng/mL） was significantly higher than those in BPH （33.2 ± 7.4 ng/mL） and healthy （24.7 ± 7.3 ng/mL） subjects （P 〈 0.001）. Second, post-operative serum HMGB 1 was 55.03 ± 11.00 ng/mL, which significantly differed from the pre-operative level （P= 0.005）.Post-operative serum HMGB1 in the recurrence group significantly different from that in the recurrence-free group （70.8 ± 2.7 vs. 55.0± 10.8 ng/mL）. Serum HMGB1 in the three metastatic cases were significantly higher than in the nine cases of local recurrence （94.2 ± 17.9 vs. 73.1 ±7.9 ng/mL）. The single diagnostic value of serum HMGB 1 was more sensitive than PSA in predicting the recurrence of Pca after local treatment （83.3% vs. 66.7%）, and the overall diagnostic specificity was higher than that of PSA alone （95.6% vs. 82.4%）. Third, serum HMGB1 in Pca patients after cryotherapy was related to the clinical stage and recurrence （P 〈 0.001）, but was not correlated with the Gleason score. Conclusion： Our findings indicated that serum HMGB1 levels were higher in Pca sub- jects, suggesting that serum HMGB1 can be used as a predictive and prognostic factor. Moreover, co-detection of serum HMGB1 and PSA can improve the early diagnos

关 键 词：高迁移率族蛋白B1 前列腺癌 肿瘤标记 复发 预后 

分 类 号：R737.25[医药卫生—肿瘤]