PHI／PCA3在前列腺癌早期诊断中的应用价值探讨  

The value of PHI/PCA3 in the early diagnosis of prostate cancer

作　　者：谭思嘉 许露伟[1] 徐郑[1] 吴剑平[1] 梁凯[1] 贾瑞鹏[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)泌尿外科,210006

出　　处：《中华医学杂志》2016年第2期100-103,共4页National Medical Journal of China

摘　　要：目的探讨前列腺健康指数（PHI）以及前列腺癌基因3（PCA3）在前列腺癌（PCa）早期诊断中的应用价值。方法选择190例血清前列腺特异性抗原（PSA）异常或直肠指检异常的住院患者作为研究对象，均行经直肠前列腺穿刺活检（其中11例行重复活检），另外选择25例血清PSA正常的成年男性作为对照。分别采用免疫荧光法和环介导等温扩增法（LAMP）检测PHI以及PCA3，计算PHI、PCA3在诊断PCa中的敏感性、特异性，绘制ROC曲线，探索两者与Gleason评分、临床分期间的关系。结果190例患者中89例经前列腺穿刺活检病理诊断为PCa，101例诊断为良性前列腺增生症（BPH）；外周血PCA3检测的敏感性和特异性分别为85．4％、92．1％；ROC曲线下面积PHI（0．727）〉PSA（0．699），且PHI与Gleason评分、临床分期呈正相关。结论PHI、PCA3具有优秀的检测效力，与单一血清PSA检测相比，联合检测PHI、PCA3可显著提升诊断的特异性，可为PCa的早期诊断提供一种新途径。Objective To investigate the value of prostate health index （PHI） and prostate cancer gene 3 （PCA3） in the early diagnosis of prostate cancer （PCa）. Methods A total of 190 patients with abnormal serum prostate specific antigen （PSA） or abnormal digital rectal examination were enrolled. They were all underwent initial biopsy and 11 of them were also underwent repeated biopsy. In addition, 25 healthy cases （with normal digital rectal examination and PSA 〈 4 ng/ml） were the control group. The PHI and PCA3 were detected by using immunofluorescence and Loop-Mediated Isothermal Amplification （LAMP）. The sensitivity and specificity of diagnosis were determined by ROC curve. In addition, the relationship between PHI/PSA and the Gleason score and clinical stage were analyzed. Results A total of 89 patients were confirmed PCa by Pathological diagnosis. The other 101 patients were diagnosed as benign prostatic hyperplasia （BPH）. The sensitivity and specificity of PCA3 test were 85.4% was 92. 1%. Area under curve （AUC） of PHI is higher than AUC of PSA （0. 727 〉 0. 699）. The PHI in peripheral blood was positively correlated with Gleason score and clinical stage. Conclusions The detection of PCA3 and PHI shows excellent detecting effectiveness. Compared with single PSA, the combined detection of PHI and PCA3 improved the diagnostic specificity. It can provide a new method for the early diagnosis in prostate cancer and avoid unnecessary biopsies.

关 键 词：前列腺癌 前列腺癌基因3 前列腺健康指数 血清PSA 

分 类 号：R737.25[医药卫生—肿瘤]