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目的:探讨尿沉渣PSGR评分在前列腺癌患者中的诊断作用。方法:2010年1月~2013年10月收集299例在我院行前列腺穿刺患者前列腺按摩后尿液,应用实时定量PCR检测尿沉渣中PSGR mRNA和PSA mRNA的表达。PSGR评分使用PSGR mRNA/PSA mRNA×1 000计算;PSGR评分的预测作用使用ROC曲线分析并与血清PSA进行比较。结果:可分析样本比例为81.94%(245/299)。所有患者和PSA“灰区”患者前列腺穿刺阳性率分别为33.46%(83/245)和27.05%(33/122)。前列腺穿刺阳性患者PSGR评分明显高于前列腺穿刺阴性患者(P<0.001)。经ROC曲线分析,在所有患者中,血清tPSA、PSGR评分和两者合用的曲线下面积分别为0.584、0.687和0.713。PSGR评分与血清总PSA诊断价值比较差异无统计学意义(P=0.052),但两者合用优于单用血清tPSA(P=0.002)。当处于PSA“灰区”时,血清tPSA、PSGR评分和两者合用的曲线下面积分别为0.525、0.727和0.731。PSGR评分的诊断价值明显优于血清tPSA(P=0.004)。结论:PSGR评分在前列腺穿刺患者中有良好的预测作用,血清tPSA和PSGR评分联合应用可提高预测总体患者的准确性,单用PSGR评分对PSA“灰区”患者有较好的预测作用。
Objective: To investigate the diagnostic value of urine sediment PSGR score in patients with prostate cancer. Methods: From January 2010 to October 2013, 299 cases of prostatic ureas were collected from patients undergoing prostate biopsy in our hospital. The expression of PSGR mRNA and PSA mRNA in urine sediment was detected by real-time quantitative PCR. The PSGR score was calculated using PSGR mRNA / PSA mRNA × 1 000; the predictive value of PSGR score was analyzed using ROC curve and compared with serum PSA. Results: The proportions of analyzable samples were 81.94% (245/299). The positive rates of prostate biopsy in all patients and PSA “gray zone ” were 33.46% (83/245) and 27.05% (33/122), respectively. PSGR score was significantly higher in prostate-positive patients than in prostate-negative patients (P <0.001). According to ROC curve analysis, the area under the curve of tPSA, PSGR and the combined use of serum tPSA, 0.587 and 0.713 in all patients were 0.584, 0.687 and 0.713, respectively. There was no significant difference between PSGR score and total serum PSA (P = 0.052), but the combination of PSGR and serum PSA was superior to single serum tPSA (P = 0.002). The area under the curve for tPSA, PSGR, and the combination of the two was 0.525, 0.727, and 0.731, respectively, for the PSA “gray zone”. The diagnostic value of PSGR was significantly better than that of serum tPSA (P = 0.004). CONCLUSIONS: The PSGR score has a good predictive value in patients with prostatic puncture. The combination of serum tPSA and PSGR scores can improve the accuracy of predicting the overall patient. PSGR score alone has better predictive value for patients with PSA “gray zone ” .