前列腺特异性抗原同源异构体2及其衍生物对血清前列腺特异性抗原4~10μg/L前列腺病变患者的临床诊断价值  

Clinical diagnostic value of prostate-specific antigen isoform 2 and its derivatives in patients with serum prostate-specific antigen 4-10μg/L

作　　者：江唯 黄雅为[2] 冯梦婷 谢超 李志华 方亮 汪建焜 JIANG Wei;HUANG Yawei;FENG Mengting;XIE Chao;LI Zhihua;FANG Liang;WANG Jiankun(The First People's Hospital of Jingdezhen,Jingdezhen,Jiangxi,333000,China;The Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330006,China)

机构地区：[1]景德镇市第一人民医院,江西景德镇333000 [2]南昌大学第二附属医院,江西南昌330006

出　　处：《当代医学》2024年第13期10-14,共5页Contemporary Medicine

基　　金：景德镇市科技计划项目(20211SFZC022)。

摘　　要：目的探讨前列腺特异性抗原(PSA)同源异构体2(P2PSA)及其衍生物在血清PSA 4~10μg/L前列腺病变患者临床诊断中的应用。方法选取2021年6月至2022年6月景德镇第一人民医院及南昌大学第二附属医院收治的血清PSA 4~10μg/L的52例前列腺病变患者作为研究对象,根据直肠超声引导下前列腺穿刺活检结果分为实验组(前列腺癌)与对照组(良性前列腺增生),每组26例。两组均行血清标志物检测[总PSA(tPSA)、P2PSA及百分比P2PSA(%P2PSA)、游离PSA(fPSA)、前列腺健康指数(PHI)],比较两组血清标志物,采用Logistic分析法分析血清标志物检测与前列腺癌的相关性,采用Spearman分析法分析血清标志物与前列腺癌侵袭性、淋巴结转移风险的相关性,绘制ROC曲线分析血清标志物对前列腺癌的诊断效能。结果两组tPSA水平比较差异比较无统计学意义;实验组P2PSA水平、%P2PSA、PHI水平均高于对照组,fPSA水平低于对照组,差异有统计学意义(P<0.05)。Logistic分析结果显示,tPSA与前列腺癌无相关性;P2PSA、%P2PSA、PHI均与前列腺癌呈正相关(P<0.05);fPSA与前列腺癌呈负相关(P<0.05)。Spearman分析结果显示,tPSA与前列腺癌侵袭性、淋巴结转移风险无相关;P2PSA、%P2PSA、PHI均与前列腺癌侵袭性、淋巴结转移风险均呈正相关(P<0.05);fPSA与前列腺癌侵袭性、淋巴结转移风险均呈负相关(P<0.05)。ROC曲线分析结果显示,P2PSA、%P2PSA、fPSA、PHI诊断前列腺癌的AUC分别为0.783、0.746、0.740、0.777,灵敏度分别为76.92%、65.38%、69.23%、61.54%,特异度分别为69.23%、80.77%、73.08%、80.77%,截断值分别为>18.80μg/L、>1.57、≤1.52μg/L、>4.73,均具备一定的诊断效能(AUC>0.7);tPSA诊断前列腺癌的AUC为0.525,诊断效能较差。结论P2PSA、%P2PSA、fPSA、PHI在血清PSA 4~10μg/L前列腺病变患者临床诊断中均具备一定的诊断效能,且P2PSA、%P2PSA、fPSA、PHI与前列腺癌侵袭性及淋巴结转移风险�Objective To investigate the application of prostate-specific antigen(PSA)isoform 2(P2PSA)and its derivatives in the clinical diagnosis of prostate disease patients with serum PSA of 4-10μg/L.Methods A total of 52 patients with prostate disease with serum PSA of 4-10μg/L admitted to the First People's Hospital of Jingdezhen and the Second Affiliated Hospital of Nanchang University from June 2021 to June 2022 were selected as the study subjects,and they were divided into the experimental group(prostate cancer)and the control group(benign prostatic hyperplasia)according to the results of prostate biopsy guided by rectal ultrasound,with 26 cases in each group.Serum markers(total PSA[tPSA],P2PSA and percentage P2PSA[%P2PSA],free PSA[fPSA],prostate health index[PHI])were detected in the two groups,and the serum markers were compared between the two groups,Logistic analysis was used to analyze the correlation between serum markers and prostate cancer,Spearman analysis was used to analyze the correlation between serum markers and the risk of prostate cancer invasion and lymph node metastasis,and ROC curve was drawn to analyze the diagnostic efficacy of serum markers on prostate cancer.Results There was no significant difference in tPSA level between the two groups;the level of P2PSA,%P2PSA and PHI in the experimental group were higher than those in the control group,and the level of fPSA was lower than that in the control group,and the differences were statistically significant(P<0.05).Logistic analysis showed that there was no correlation between tPSA and prostate cancer;P2PSA and PHI were positively correlated with prostate cancer(P<0.05);fPSA was negatively correlated with prostate cancer(P<0.05).Spearman analysis showed that there was no correlation between tPSA and the risk of prostate cancer invasion and lymph node metastasis;P2PSA,%P2PSA and PHI were positively correlated with prostate cancer invasiveness and lymph node metastasis risk(P<0.05);fPSA was negatively correlated with the risk of prostate cancer inva

关 键 词：前列腺特异性抗原同源异构体2 前列腺病变 临床诊断 

分 类 号：R737.25[医药卫生—肿瘤]