血清总前列腺特异性抗原轻度异常时可溶性人白细胞抗原-G对前列腺癌的诊断价值  

Diagnostic value of serum sHLA-G levels in prostate cancer of patients with slight abnormal level of tPSA

作　　者：廖解志[1] LIAO Jie - zhi(Department of Urology, Huzhou Central Hospital, Huzhou, Zhejiang 313000, Chin)

机构地区：[1]湖州市中心医院泌尿外科,浙江湖州313000

出　　处：《中国卫生检验杂志》2018年第5期588-590,605,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨中老年患者血清总前列腺特异性抗原(t PSA)为4.00μg/L^20.00μg/L时,可溶性人白细胞抗原-G(s HLA-G)对前列腺癌的诊断及鉴别诊断价值。方法收集t PSA为4.00μg/L^20.00μg/L的血清,检测t PSA、s HLA-G的水平,并行前列腺穿刺活组织检查(前列腺活检),经病理活检筛选出前列腺癌(PCa)、前列腺炎(AIP)、前列腺增生(BPH)患者共106例。比较3组间及各组与对照组t PSA、s HLA-G的差异。结果经病理活检确诊PCa24例,AIP 12例,BPH 70例,前列腺癌、前列腺炎、前列腺增生3组患者之间t PSA比较差异均无统计学意义(P>0.05),前列腺癌与前列腺炎、前列腺增生患者间s HLA-G比较差异均有统计学意义(P<0.05);t PAS的诊断界值为11.0 ng/ml,敏感度和特异度分别为57.8%和72.5%;s HLA-G的诊断界值为1.70 U/ml,敏感度和特异度分别为69.2%和83.6%;s HLA-G诊断前列腺癌的敏感度和特异度均高于t PAS。结论 t PSA为4.00μg/L^20.00μg/L时,s HLA-G可作为前列腺癌的早期筛查和鉴别诊断的有效肿瘤标志物,s HLA-G的检测有助于弥补t PSA对前列腺癌诊断的不足,减少不必要的前列腺活检。Objective To investigate the diagnostic value of soluble human leukocyte antigen-G（ s HLA-G） in the diagnosis and differential diagnosis of prostate cancer in patients with middle-aged and elderly patients with serum total prostate specific antigen（ t PSA） of 4. 00 μg/L-20. 00 μg/L. Methods Serum samples with t PSA ranging from 4. 00 μg/L to 20. 00 μg/L were collected for the detection of t PSA and s HLA-G. Prostate biopsy was carried out,and 106 cases of prostate cancer（ Pca）,prostatitis（ AIP）,and hyperplasia（ BPH） were detected. The differences of t PSA and s HLA-G between the three groups and the normal healthy control group were compared. Results Pathological biopsy confirmed Pca in 24 cases,AIP in12 cases,BPH in 70 cases,and the differences of t PSA among prostate cancer,prostatitis,benign prostatic hyperplasia patients showed no statistical significance（ P〈0. 05）; the differences of s HLA-G between prostate cancer and prostatitis,between prostate cancer and prostate hyperplastic were statistically significant（ P〈0. 05）. The diagnostic threshold of t PAS was11. 0 ng/ml,and the sensitivity and specificity were 57. 8% and 72. 5%,respectively. The diagnostic threshold of s HLA-G was 1. 70 U/ml,and the sensitivity and specificity were 69. 2% and 83. 6%,respectively; the sensitivity and specificity of s HLA-G in the diagnosis of prostate cancer were higher than t PAS. Conclusion When t PSA was within 4. 00 μg/L-20. 00 μg/L,and s HLA-G can be used as an effective tumor marker for early screening and differential diagnosis of prostate cancer. The detection of s HLA-G can help to make up for the shortage of t PSA for prostate cancer diagnosis and reduce unnecessary prostate biopsy.

关 键 词：前列腺特异性抗原 可溶性人白细胞抗原-G 前列腺癌 前列腺炎 前列腺增生 

分 类 号：R737.25[医药卫生—肿瘤]