uPCA3mRNA、tPSA、fPSA/tPSA、PSAD对PSA灰区前列腺癌诊断的临床意义  

Clinic Significance of uPCA3mRNA, tPSA, FPSA/TPSA Ratio and PASD for Prostate Cancer with PSA in Diagnostic Gray Zone

作　　者：刘敏[1] 吴振启[1] 李慧峰[1] 张菊根[1] 朱延军[1] 郭剑明[1] 

机构地区：[1]复旦大学附属中山医院青浦分院泌尿科,上海201701

出　　处：《现代生物医学进展》2015年第27期5336-5339,共4页Progress in Modern Biomedicine

基　　金：上海市卫计委课题(尿PCA3m RNA对PSA灰区前列腺癌诊断价值的研究)(20114234)

摘　　要：目的:探讨u PCA3m RNA、t PSA、f PSA/t PSA、PSAD对PSA灰区前列腺癌的诊断价值。方法:经前列腺穿刺活检诊断为前列腺增生(BPH)111例和前列腺癌(PCa)89例,测定血清t PSA、f PSA与前列腺体积,所有病例均计算f PSA/t PSA、PSAD。用RT-PCR的方法检测PSA m RNA、PCA3 m RNA的含量,以PCA3 m RNA/PSA m RNA表示PCA3 m RNA的含量。比较两组间t PSA、f PSA/t PSA、PSAD及PCA3m RNA各指标的差异,分析各指标在ROC曲线下的面积、各指标的诊断敏感性和特异性。结果:PCa组的f PSA/t PSA较BPH组降低(P<0.01),PCa组的t PSA、PSAD及PCA3 m RNA较BPH组均升高(P<0.01)。t PSA、f PSA/t PSA、PSAD及PCA3 m RNA在ROC曲线下的面积从大到小依次是PCA3 m RNA>PSAD>f PSA/t PSA>t PSA。当PCA3 m RNA和PSAD临界值分别为0.27和0.15时,诊断PCa的敏感性和特异性分别是86.5%和77.5%,80.9%和55.9%。结论:u PCA3m RNA、f PSA/t PSA、PSAD的测定能显著提高灰区PCa诊断的敏感性和特异性,且u PCA3 m RNA诊断效能最高。Objective： To compare the diagnostic value of u PCA3 m RNA, t PSA, f PSA/t PSA ratio and PASD for prostate cancer with prostate specific antigen（PSA） in diagnostic gray zone. Methods： Prostate biopsy was performed in 200 patients whose t PSA were between 4 ng/m L^10 ng/m L（diagnostic gray zone）. Among these patients, 111 of them were diagnosed with benign prostatic hyperplasia（BHP group） and 89 with prostate cancer（PCa group） by pathology. The t PSA and f PSA in serum were measured by chemiluminescence-assay. The volume of prostate was measured by transrectal ultrasound. f PSA/t PSA ratio and PSAD were computed and analyzed.The difference of u PCA3 m RNA, t PSA, f PSA/t PSA ratio and PASD between the PCa group and BPH group were compared, and the area under ROC curve, the sensitivity and specificity were analyzed. Results： The f PSA/t PSA ratio of the PCa group was significantly lower than that of the BPH group. The levels of t PSA, PSAD and PCA3 m RNA were significantly higher in PCa group than in BPH group（both P〈0.01）. The area under ROC curve of these indexes in descending order was PCA3 m RNA, PSAD, f PSA/t PSA radio and t PSA.When the critical value of PCA3 m RNA and PSAD were 0.27 and 0.15, the sensitivity and specificity of diagnosing PCa were 86.5% and77.5%, 80.9% and 55.9%, respectively. Conclusions： Detection of the u PCA3 m RNA, f PSA/t PSA ratio and PASD can improve the diagnosis of prostate cancer with PSA in diagnostic gray zone, and the value of u PCA3 m RNA in urine was highest for the diagnosis of prostate cancer.

关 键 词：PCA3mRNA 前列腺特异抗原 游离PSA/总PSA PSA密度 

分 类 号：R737.25[医药卫生—肿瘤]