外周血前列腺癌基因3前列腺特异抗原F/T比值以及前列腺特异性抗原密度联合检测对前列腺癌的诊断作用  

Diagnostic function of combined detection of PCA3,PSA,F/T ratio and PSAD in prostate cancer

作　　者：李业山[1] 王兆鹏 

机构地区：[1]中国石油天然气集团公司中心医院泌尿外科,廊坊065000 [2]承德学院附属医院内科

出　　处：《山西医药杂志》2016年第18期2099-2102,共4页Shanxi Medical Journal

基　　金：河北省2014年度医学科学研究重点课题计划(ZL20140234)

摘　　要：目的探讨外周血前列腺癌基因3(PCA3)、前列腺特异抗原(PSA)、游离PSA(f PSA)/总PSA(t PSA)(F/T)比值以及前列腺特异性抗原密度(PSAD)联合检测对前列腺癌的诊断作用。方法以我院2014年7月至2015年12月医治的79例前列腺疾病患者为研究对象,将其中40例前列腺癌患者作为A组,39例前列腺增生患者作为B组,同时选取健康体检者30名作为健康对照组,3组受试者均行直肠超声检查,应用Trizol总RNA抽提试剂盒说明书对血清PCA3进行检测,采用化学发光免疫染色法对血清PSA进行测定,并计算F/T值、PSAD值。结果 A组F/T值均显著低于B组和健康对照组,PCA3、PSAD和PSA值均显著高于B组及健康对照组;B组F/T值均显著低于健康对照组,PSAD和PSA值显著高于健康对照组(P<0.05);PSA灵敏度为72.5%,特异度为69.8%;F/T灵敏度为77.9%,特异度为58.4%;PSAD灵敏度为74.1%,特异度为74.8%;PCA3灵敏度为82.6%,特异度为90.4%;联合检测灵敏度为83.0%;特异度为92.3%;PCA3、F/T、PSA及PSAD联合评估前列腺癌预后的ROC曲线下面积(AUC)为0.82,优于各项指标单独评估AUC值。结论 PSA、PCA3、F/T及PSAD值联合检测能够提高前列腺癌检出率,临床应用价值较大。Objective To explore diagnostic function of combined detection of peripheral blood prostate cancer gene 3（PCA3）,prostate specific antigen（PSA）,free PSA（fPSA）/total PSA（tPSA）（F/T）and prostate specific antigen density（PSAD）in prostate cancer.Methods Seventy-nine cases of patients with prostatic diseases in our hospital from July 2014 to December 2015 were selected as the research subjects,among whom 40 cases with prostate cancer were as the A group,and the 39 cases with benign prostatic hyperplasia as the B group,and another 30 cases of healthy physical examination were selected as the healthy control group at the same time.The subjects of the 3groups were examined by ultrasonography,and the expressions of PCA3 and PSA were detected by immunohistochemistry and enzyme-linked immunosorbent assay,then the expressions of F/T and PSAD were calculated.Results The values of PCA3 and F/T in the A group were significantly lower than those in the B group and healthy control group,and the values of PSAD and PSA were significantly higher than those in the B group and healthy control group.And the values of PCA3 and F/T in the B group were significantly lower than those in the healthy control group,and the values of PSAD and PSA were significantly higher than those in the healthy control group（P〈0.05）.The sensitivity of PSA was 72.5%,with specificity of 69.8%.And sensitivity of the F/T was 77.9%,with specificity of 58.4%.Sensitivity of the PSAD was 74.1%,with specificity of74.8%.Sensitivity of the PCA3 was 84.6%,with specificity of 78.7%.And the sensitivity of combination detection was 80.0%,with the specificity of 82.3%.Area under ROC curve was 0.82 after treatment of PCA3,F/T,PSA and PSAD in combined evaluation of prostate cancer,which was better than the various indicators to assessvalues of AUC.Conclusion The combined detection of PSA,PCA3,F/T and PSAD can improve the detection rate of prostate cancer,and the clinical application value is high.

关 键 词：基因 前列腺肿瘤 前列腺特异抗原 前列腺特异性抗原密度 

分 类 号：R737.25[医药卫生—肿瘤]