摘要
目的 探讨前列腺特异性膜抗原(prostate specific membrane antigen, PSMA)在前列腺癌组织及外周血中的表达情况,分析其与Gleason评分的关系及在早期诊断和预后中的价值。方法 2015年3月~2020年6月于我院诊治的前列腺癌病人270例,前列腺增生病人50例。收集病人的石蜡切片标本,免疫组织化学染色(immumohistochemical staining, IHC)检测组织中的PSMA表达情况,分析其与病人Gleason评分的相关性,并采用Kaplan-Meier方法法对比PSMA阳性表达组和阴性表达组病人总体生存(overall survival, OS)和无生化复发生存(biochemical relapse-free survival, BRFS)情况。采用酶联免疫吸附法(ELISA)检测两组病人血清中PSMA含量,采用受试者工作曲线(ROC)评价PSMA作为诊断标志物的价值。结果 在270例前列腺癌组织中,PSMA表达阳性221例(81.9%);50例前列腺增生组织中,PSMA表达阳性24例(48.0%),两组比较差异有统计学意义(,P<0.05)。Gleason评分>7分的病人PSMA阳性表达率较Gleason评分≤7分高,差异有统计学意义(P<0.05)。PSMA阳性表达组的中位OS为24个月,中位BRFS为17个月,均低于PSMA阴性表达组(中位OS52个月,中位BRFS:45个月),差异有统计学意义(P<0.05)。前列腺癌病人血清PSMA含量为(17.97±6.66)μg/L,前列腺增生组为(7.90±5.03)μg/L,差异有统计学意义(P<0.05)。ROC结果显示,以血清PSMA>17.50μg/L为截断值时,曲线下面积(AUC)为0.845,诊断灵敏度为71.1%,特异度为82%。结论 前列腺癌组织中PSMA呈现高表达,与Gleason评分密切相关,且其表达与病人更差的预后相关,血清中PSMA水平可以作为前列腺癌诊断指标。
Objective To investigate the expression of prostate specific membrane antigen(PSMA) in prostate cancer tissues and peripheral blood, and to analyze the relationship between PSMA and Gleason score and its value in early diagnosis and prognosis.Methods Clinical data of 270 patients with prostate cancer and 50 patients with BPH treated in our hospital from March 2015 to June 2020 were retrospectively analyzed.Immunohistochemical staining(IHC) was used to detect PSMA expression in tissues, and analyze the correlation between PSMA expression and Gleason score.Kaplan-meier method was used to compare Overall Survival(OS) and biochemical relapse-free Survival(BRFS) of PSMA positive and negative groups.Finally, enzyme linked immunosorbent assay(ELISA) was used to detect the content of PSMA in serum of the two groups, and receiver operating curve(ROC) was used to evaluate the value of PSMA as a diagnostic marker.Results PSMA expression was positive in 221 of 270(81.9%) prostate cancer tissues and was positive in 24 of 50(48.0%) prostatic hyperplasia tissues.The positive rate of prostatic hyperplasia tissues was lower than that of prostate cancer group(P<0.05) the positive expression rate of PSMA in patients with Gleason score >7 was higher than that in patients with Gleason score ≤7(P<0.05).The median OS was 24 months and the median BRFS was 17 months in the PSMA positive group, which were significantly lower than those in the PSMA negative group(median OS:52 months and median BRFS:45 months),with statistically significant differences(P<0.05).The serum PSMA content of prostate cancer patients was(17.97±6.66)μg/L,which was higher than that of prostate hyperplasia group[(7.90±5.03)μg/L],and the difference was statistically significant(P<0.05).ROC results showed that when serum PSMA > 17.50 μg/L was used as the cut-off value, the area under the curve(AUC) was 0.845,the diagnostic sensitivity was 71.1%,and the specificity was 82%.Conclusion The high expression of PSMA in prostate cancer tissue is closely related to Glea
作者
季金涛
康波
苏燕胜
JI Jintao;KANG Bo;SU Yansheng(Department of Urology,986th Hospital of Air Force,Xi'an 710054,China)
出处
《临床外科杂志》
2022年第9期885-888,共4页
Journal of Clinical Surgery
基金
2019年度学科助推计划项目(XJZT19ML22)。
关键词
前列腺癌
前列腺特异性膜抗原
诊断
预后
prostate cancer
prostate specific membrane antigen
diagnosis
prognosis
