尿PCA3对预测前列腺癌及侵袭性的临床意义

刘亚巍; 杜鹏; 王硕; 蔡小兵; 汤星星; 杨勇

doi:10.13201/j.issn.1001-1420.2017.09.005

尿PCA3对预测前列腺癌及侵袭性的临床意义

- 1 联参警卫局卫生保健处(北京, 100017);
- 2 北京大学肿瘤医院泌尿外科
基金项目:
军委总后勤部保健专项基金（编号12BJZ25）

详细信息

通讯作者: 杜鹏,E-mail:yoya_urology@sina.com

中图分类号: R737.25

收稿日期: 2017-06-10

Urinary PCA3 as a new predictive biomarker in prostate cancer aggression

- 1 Health Division of Guard Bureau, General Staff Department of People's Liberation Army, Beijing, 100017, China;
- 2 Department of Urology, Peking University Cancer Hospital&Institute

More Information

Corresponding author: DU Peng, E-mail: yoya_urology@sina.com

Received Date: 10 June 2017

摘要

摘要: 目的：前列腺抗原3 （PCA3）是基于基因的前列腺特异性生物学标记，目前已用于预测前列腺癌（PCa）的诊断。本研究将探讨尿PCA3评分在PCa诊断中的价值及预测PCa病理的潜在价值。方法：2014年7月~2015年8月，采用实时定量PCR方法对237例男性尿液PCA3表达进行检测，其中包括健康男性、前列腺炎（CP）、良性前列腺增生（BPH），以及肾癌、膀胱癌及PCa等其他癌症患者。前列腺系统活检者均因直肠指诊、血清PSA及影像学检查怀疑PCa。对于确诊为PCa患者，收集包括Gleason评分及TNM分期在内的信息，采用Spearman相关分析评估PCA3与这些参数的相关性，采用ROC分析评估PCA3评分的预测价值。结果：共纳入237例患者，其中健康男性35例，慢性前列腺炎31例，良性前列腺增生30例，PCa74例，肾癌21例，膀胱癌25例及其他泌尿系肿瘤21例。结果显示PCa患者其尿PCA3评分明显升高（P<0.05），高分级PCa升高尤为明显（t=4.411，P<0.05）。双变量相关分析显示PCA3评分与Gleason分级呈正相关（r=0.244，P=0.036），但与PSA （r=-0.019，P>0.05）及TNM分期无相关性（r=0.069，P>0.05）。ROC分析进一步显示PCA3评分在PCa诊断预后预测作用明显优于血清PSA。结论：尿PCA3评分可能成为预测PCa有价值的生物标记，更高的PCA3评分与PCa的侵袭性相关。
- 尿PCA3 /
- 前列腺癌 /
- 生物学标记 /
- 诊断 /
- 侵袭性
Abstract: Objective: Prostate cancer antigen 3 (PCA3) is a prostate specific gene-based marker, and nowadays it has been used in predicting the presence of prostate cancer (PCa) in men.In the present study, we explored the effectiveness of urinary PCA3 score in PCa diagnosis and its potential role in predicting the presence of pathological significance for PCa.Method: From July 2014 to August 2015, quantitative real-time PCR was used to detect the differential expression of urinary PCA3 in 237 men including healthy people who matched age but without cancer or infection, and patients with chronic prostatitis (CP), prostatic hyperplasia (BPH), PCa, kidney cancer, bladder cancer and other cancers.Patients were initially diagnosed as PCa based on digital rectal examination (DRE), PSA kinetics and family history of PCa.Prior to biopsy, the patients underwent clinical and biological evaluation including DRE and transrectal ultrasonography (TRUS).Spearman correlation was used for comparison and evaluation of correlations between PCA3 score and concentration of PSA, Gleason score and TNM stage.Receiver operating curve (ROC) analysis was conducted to explore the predictive value of PCA3 score.Result: The 237 subjects included 35 healthy people, 31 patients with CP, 30 patients with BPH, 74 patients with PCa, 21 patients with kidney cancer, 25 patients with bladder cancer and 21 patients with other urogenital cancers.The PCA3 score was found significantly higher in urine of PCa patients (P<0.05), and especially in highgrade PCa (t=4.411, P<0.05).Bivariate correlation analysis indicated that the higher presence of PCA3 score was positively correlated with Gleason grade (r=0.244, P=0.036) but no correlation with PSA (r=-0.019, P>0.05) or TNM stage (r=0.069, P>0.05).Moreover, ROC analysis further showed that PCA3 score was a better prognosticator compared to PSA in diagnosing PCa.Conclusion: The urinary PCA3 score may be a valuable tool in identifying patients at risk of PCa.Obviously, a higher PCA3 score is associated with PCa aggression.
- urinary prostate cancer antigen 3 /
- prostate cancer /
- biomarker /
- diagnosis /
- aggression

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