血清PSA、PSAD和HMGB1水平检测对老年前列腺癌的诊断价值  

Diagnostic value of serum prostate specific antigen,prostate specific antigen density and high mobility group protein B1 levels in elderly patients with prostate cancer

作　　者：刘毅豪[1] 黄智峰[1] 吴松[1] 郑东翔[1] 梁琼琼 杜子媚 LIU Yi-hao;HUANG Zhi-feng;WU SONG;ZHENG Dong-xiang;LIANG Qiong-qiong;DU Zi-mei(The First Department of General Surgery,Zhongshan Traditional Chinese Medicine Hospital,Zhongshan 528400,Guangdong,CHINA)

机构地区：[1]中山市中医院外一科,广东中山528400

出　　处：《海南医学》2021年第12期1527-1530,共4页Hainan Medical Journal

摘　　要：目的研究老年前列腺癌患者血清前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)和高迁移率族蛋白(HMG)B1水平的变化及其临床诊断价值。方法选取中山市中医院2013年3月至2018年3月期间收治的80例老年前列腺癌患者作为研究组,选取我院同期体检健康者80例作为对照组。所有受检者均于清晨空腹抽取静脉血5 m L,分离血清后放置冰箱待测,采用酶联免疫法(ELISA)测定血清PSA、PSAD、HMGB1水平,并比较两组受检者血清PSA、PSAD、HMGB1水平差异。采用χ^(2)检验比较血清PSA、PSAD、HMGB1单独诊断与联合诊断情况,采用受试者工作特征(ROC)曲线评价血清PSA、PSAD、HMGB1对老年前列腺癌患者的诊断价值。结果研究组患者的血清PSA、PSAD和HMGB1水平分别为(48.23±7.56)ng/m L、(0.42±0.12)ng/(m L·m^(3))、(55.23±11.12)ng/m L,明显高于对照组的(2.12±0.28)ng/m L、(0.05±0.02)ng/(m L·m^(3))、(9.45±2.45)ng/m L,差异均有统计学意义(P<0.05);PSA单独检测敏感度为54.16%、特异性为37.50%,PSAD单独检测敏感度为56.94%、特异性为50.00%,HMGB1单独检测敏感度为59.77%、特异性为62.50%,均明显低于三者联合检测的84.72%和87.50%,差异均有统计学意义(P<0.05);PSA、PSAD和HMGB1联合诊断在ROC曲线下的面积分别为0.911、0.937、0.874、0.984,95%可信区间分别为0.893~0.935、0.915~0.952、0.794~0.902、0.932~0.993,根据ROC曲线可得前列腺癌诊断的最佳临界值分别为PSA>8.47 ng/mL、PSAD>0.17 ng/(m L·m3)、HMGB1>7.38 ng/m L、联合诊断>9.32 ng/m L。结论老年前列腺癌患者的血清PSA、PSAD、HMGB1水平明显升高,联合检测可提高临床诊断的敏感度和特异性,对疾病的预防和治疗具有重要价值。Objective To study the changes of serum prostate specific antigen(PSA),prostate specific antigen density(PSAD)and high mobility group protein(HMG)B1 levels in elderly patients with prostate cancer and their clinical diagnostic value.Methods A total of 80 elderly patients with prostate cancer in Zhongshan Traditional Chinese Medicine Hospital from March 2013 to March 2018 were selected as the study group,and 80 healthy people in our hospital during the same period were selected as the control group.5 mL of venous blood was collected from all subjects in the morning,and the serum was separated and stored in the refrigerator for testing.The serum levels of PSA,PSAD and HMGB1 were determined by enzyme-linked immunosorbent assay(ELISA),and the differences of serum levels of PSA,PSAD and HMGB1 between the two groups were compared.Chi square test was used to compare the diagnosis of serum PSA,PSAD and HMGB1.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum PSA,PSAD and HMGB1 in elderly patients with prostate cancer.Results The serum levels of PSA,PSAD and HMGB1 in the study group were(48.23±7.56)ng/mL,(0.42±0.12)ng/(mL·m^(3)),(55.23±11.12)ng/mL,which were significantly higher than(2.12±0.28)ng/mL,(0.05±0.02)ng/(mL·m^(3)),(9.45±2.45)ng/mL in the control group(P<0.05).The sensitivity and specificity of PSA,PSAD and HMGB1 were 54.16%and 37.50%,56.94%and 50.00%,59.77%and62.50%respectively,which were significantly lower than 84.72%and 87.50%of combined detection of the three(P<0.05).The area under the ROC curve of combined diagnosis of PSA,PSAD and HMGB1 was 0.911,0.937,0.874 and0.984,and the 95%confidence intervals were 0.893-0.935,0.915-0.952,0.794-0.902 and 0.932-0.993.According to the ROC curve,the optimal cut-off values for prostate cancer diagnosis were PSA>8.47 ng/m L,PSAD>0.17 ng/(m L·m3),HMGB1>7.38 ng/m L and combined diagnosis>9.32 ng/m L.Conclusion The serum levels of PSA,PSAD and HMGB1 in elderly patients with prostate cancer increased significantly,and combin

关 键 词：老年 前列腺癌 前列腺特异性抗原 前列腺特异性抗原密度 高迁移率族蛋白 诊断价值 

分 类 号：R737.25[医药卫生—肿瘤]