摘要
目的探讨尿前列腺癌基因3(PCA3)评分对前列腺特异抗原(PSA)低值区域(10~20 ng/mL)患者前列腺癌的诊断价值。方法选择2016年7月至2019年6月陆军军医大学第二附属医院健康体检中PSA为10~20 ng/mL的患者137例,收集入组患者临床一般数据,采集外周血、直肠指诊后尿液及经直肠前列腺穿刺标本,完善血清PSA、尿PCA3 mRNA、尿PSA mRNA逆转录-聚合酶链式反应(RT-PCR)检测及穿刺病理检查。计算游离PSA比值(%fPSA)、PSA密度(PSAD)及尿PCA3评分,并采用受试者工作特征(ROC)曲线分析各肿瘤标志物潜在的诊断效能。结果137例患者中确诊前列腺癌31例,穿刺结果阴性者106例。ROC曲线分析显示尿PCA3评分的灵敏度和特异度分别为83.87%、67.92%,明显优于血清PSA(67.74%、48.11%);二者曲线下面积(AUC)比较,PCA3评分也明显高于PSA(0.757 vs.0.549,P=0.004)。PCA3评分的AUC也明显高于%fPSA(0.757 vs.0.599,P=0.041),但与PSAD的AUC比较差异无统计学意义(0.757 vs.0.625,P=0.677);且PCA3评分联合PSA检测的AUC与单独PCA3评分比较,差异无统计学意义(0.738 vs.0.757,P=0.361)。结论相比血清PSA,尿PCA3评分对PSA为10~20 ng/mL的男性具有更高的前列腺癌预测价值。
Objective To investigate the diagnostic value of urine prostate cancer antigen 3(PCA3)score for prostate cancer in the patients with low value area(10-20 ng/mL)of prostate specific antigen(PSA).Methods One hundred and thirty-seven patients with PSA 10-20 ng/mL in the healthy physical examination in Second Affiliated Hospital of the Army Military Medical University from July 2016 to June 2019 were selected.The general clinical data of the grouped subjects were collected.Peripheral blood,urine after digital rectal examination and transrectal prostate puncture biopsy specimens were collected.Serum PSA,urine PCA3 mRNA and PSA mRNA were detected by using the quantitative RT-PCR,and puncture pathological examination was performed.The ratio of free PSA(%fPSA),PSA density(PSAD),and urine PCA3 score were calculated,and the potential diagnostic efficacy of each tumor biomarker was analyzed by using the ROC curve.Results Among 137 patients,31 cases were diagnosed as prostate cancer and 106 cases were negative puncture outcomes.The ROC curve analysis showed that the sensitivity and specificity of urine PCA3 score were 83.87%and 67.92%respectively,which were significantly superior to serum PSA(67.74%,48.11%).In the comparison of the area under the curve(AUC)of urine PCA3 and PSA,the PCA3 score was also significantly higher than of the PSA score(0.757 vs.0.549,P=0.004).AUC of PCA3 score was also significantly higher than%fPSA(0.757 vs.0.599,P=0.041),but there was no statistical difference compared with AUC of PSAD(0.757 vs.0.625,P=0.677);moreover no statistically significant difference was observed in the comparison between AUC of PCA3 score combined with PSA and AUC of single PCA3 score(0.738 vs.0.757,P=0.361).Conclusion Compared with serum PSA,urine PCA3 score has a higher predictive value of prostate cancer for the male patients with PSA 10-20 ng/mL.
作者
付卫华
何凡
冯欢
孙梦佳
吴荣华
李龙坤
FU Weihua;HE Fan;FENG Huan;SUN Mengjia;WU Ronghua;LI Longkun(Department of Urologyical Surgery,Second Affiliated Hospital of Army Medical University,Chongqing 400037,China;Squadron 10,Battalion 3,College of Basic Medical Sciences,Army Military Medical University,Chongqing 400038,China)
出处
《重庆医学》
CAS
2020年第21期3565-3568,3573,共5页
Chongqing medicine
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)。
关键词
前列腺肿瘤
前列腺癌基因3
前列腺特异抗原
诊断
前列腺穿刺
prostatic neoplasms
prostate cancer antigen 3
prostate-specific antigen
diagnosis
prostate puncture
