摘要
目的探讨尿沉渣及尿外泌体中前列腺癌基因3(PCA3)评分对前列腺特异抗原(PSA)灰区(4~10 ng/mL)患者前列腺癌(PCa)的诊断价值。方法于2019年7月至2020年1月从我院健康体检中心招募PSA灰区患者120例,入组后采集其临床一般信息、外周血及直肠指检后初始尿液,并接受超声引导下经直肠前列腺穿刺活检。血液标本用于检测PSA,计算游离PSA比值(%fPSA)、PSA密度(PSAD)。尿液标本分成2份,分别用于提取尿沉渣及尿外泌体,并采用QRT-PCR检测其中PCA3、PSA表达,计算PCA3评分。ROC曲线比较分析各肿瘤标志物的诊断效能。结果最终120例患者纳入本研究,其中23例患者(19.2%)经病理活检确诊为PCa。剔除不符合标准的尿液样本后,共分析尿沉渣样本104例(尿沉渣组),尿外泌体样本95例(尿外泌体组)。2组患者中,PCa患者的PSAD和PCA3评分均明显高于非PCa患者(P<0.05),而PSA和%fPSA比较差异无统计学意义(P>0.05)。ROC曲线分析显示,尿沉渣和尿外泌体中PCA3评分诊断PCa的曲线下面积(AUC)显著大于血清PSA(P=0.042、0.027),但与%fPSA和PSAD比较差异无统计学意义(P>0.05)。结论在PSA灰区患者中,与血清PSA比较,尿沉渣及尿外泌体中PCA3评分对PCa更具预测价值。
Objective To investigate the diagnostic performance of prostate cancer gene 3(PCA3)score in urinary sediments and urinary exosomes for prostate cancer(PCa)in patients with prostate specific antigen(PSA)grey zone(4~10 ng/mL).Methods From July 2019 to January 2020,patients with PSA grey zone were recruited from the physical examination center of our hospital.The general clinical information,peripheral blood and initial urine after digital rectal examination of patients were collected,and ultrasound-guided transrectal prostate biopsy was performed.Blood samples were used to test PSA,and the free PSA ratio(%fPSA)and PSA density(PSAD)were calculated.Urine samples were divided in duplicate for extracting urinary sediments and urinary exosomes separately.QRT-PCR was used to detect the expression level of PSA and PCA3,and the PCA3 score was calculated.The diagnostic efficacy of each PCa biomarker was analyzed by the receiver operating characteristic(ROC)curve.Results A total of 120 patients were involved in the study,of which 23(19.2%)cases were diagnosed with PCa by biopsy.After excluding insufficient samples,104 urinary sediment samples(urine sediments group)and 95 urinary exosomes samples(urine exosomes group)were analyzed.In the two groups,the PSAD and PCA3 scores were significantly higher of PCa patients than those of non-PCa patients(P<0.05),but there was no significant difference between PSA and%fPSA(P>0.05).ROC curve analysis showed that AUC of PCA3 in urinary sediments and urinary exosomes for diagnosis of PCa were significantly higher than that of serum PSA(P=0.042,0.027),but there was no significant difference between%fPSA and PSAD(P>0.05).Conclusion In the patients of PSA grey zone,PCA3 score in urinary sediments and urinary exosomes shows a higher diagnostic value for PCa than serum PSA.
作者
付卫华
贾维胜
何凡
孙梦佳
陈婷婷
吴荣华
方针强
FU Wei-hua;JIA Wei-sheng;HE Fan;SUN Meng-jia;CHEN Ting-ting;WU Rong-hua;FANG Zhen-qiang(Center of Urology,Second Affiliated Hospital of Army Medical University,Chongqing 400037,China;Squadron 10,Battalion 3,College of Basic Medical Sciences,Army Medical University,Chongqing 400038,China)
出处
《局解手术学杂志》
2020年第9期734-738,共5页
Journal of Regional Anatomy and Operative Surgery
基金
重庆市社会民生科技创新专项(cstc2015shmszx120018)
第三军医大学第二附属医院临床科研项目(2015YLC24)。
