文章摘要
刘敏 吴振启 李慧峰 张菊根 朱延军 郭剑明.uPCA3mRNA、tPSA、fPSA/tPSA、PSAD对PSA灰区前列腺癌诊断的临床意义[J].,2015,15(27):5336-5339
uPCA3mRNA、tPSA、fPSA/tPSA、PSAD对PSA灰区前列腺癌诊断的临床意义
Clinic Significance of uPCA3mRNA, tPSA, FPSA/TPSA Ratio and PASDfor Prostate Cancer with PSA in Diagnostic Gray Zone
  
DOI:
中文关键词: PCA3mRNA  前列腺特异抗原  游离PSA /总PSA  PSA密度
英文关键词: PCA3mRNA  Prostate specific antigen  Free-PSA/total-PSA ratio  Prostate specific antigen density
基金项目:上海市卫计委课题(尿PCA3mRNA 对PSA灰区前列腺癌诊断价值的研究)(20114234)
作者单位
刘敏 吴振启 李慧峰 张菊根 朱延军 郭剑明 复旦大学附属中山医院青浦分院泌尿科 
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中文摘要:
      目的:探讨uPCA3mRNA、tPSA、fPSA/tPSA、PSAD对PSA 灰区前列腺癌的诊断价值。方法:经前列腺穿刺活检诊断为前列 腺增生(BPH) 111 例和前列腺癌(PCa) 89 例,测定血清tPSA、fPSA 与前列腺体积,所有病例均计算fPSA/tPSA、PSAD。用 RT-PCR 的方法检测PSA mRNA、PCA3 mRNA 的含量,以PCA3 mRNA/PSA mRNA 表示PCA3 mRNA 的含量。比较两组间 tPSA、fPSA/tPSA、PSAD 及PCA3mRNA各指标的差异,分析各指标在ROC 曲线下的面积、各指标的诊断敏感性和特异性。结果: PCa 组的fPSA/tPSA较BPH 组降低(P<0.01),PCa 组的tPSA、PSAD及PCA3 mRNA较BPH 组均升高(P<0.01)。tPSA、fPSA/ tPSA、PSAD及PCA3 mRNA在ROC 曲线下的面积从大到小依次是PCA3 mRNA>PSAD > fPSA /tPSA>tPSA。当PCA3 mRNA 和PSAD 临界值分别为0.27 和0.15 时,诊断PCa 的敏感性和特异性分别是86.5%和77.5%,80.9%和55.9%。结论:uPCA3 mRNA、fPSA/tPSA、PSAD 的测定能显著提高灰区PCa 诊断的敏感性和特异性,且uPCA3 mRNA 诊断效能最高。
英文摘要:
      Objective:To compare the diagnostic value of uPCA3mRNA, tPSA, fPSA/tPSA ratio and PASD for prostate cancer with prostate specific antigen (PSA) in diagnostic gray zone.Methods:To compare the diagnostic value of uPCA3mRNA, tPSA, fPSA/tPSA ratio and PASD for prostate cancer with prostate specific antigen (PSA) in diagnostic gray zone.Results:The fPSA/tPSA ratio of the PCa group was significantly lower than that of the BPH group. The levels of tPSA, PSAD and PCA3 mRNA were significantly higher in PCa group than in BPH group (both P<0.01). The area under ROC curve of these indexes in descending order was PCA3mRNA, PSAD, fPSA/tPSA radio and tPSA. When the critical value of PCA3mRNA and PSAD were 0.27 and 0.15, the sensitivity and specificity of diagnosing PCa were 86.5%and 77.5%, 80.9% and 55.9%, respectively.Conclusion:Detection of the uPCA3mRNA, fPSA/tPSA ratio and PASD can improve the diagnosis of prostate cancer with PSA in diagnostic gray zone, and the value of uPCA3mRNA in urine was highest for the diagnosis of prostate cancer.
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