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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。
Purpose: Prostate antigen 3 (PCA3) is a gene-based prostate-specific biomarker that has been used to predict the diagnosis of prostate cancer (PCa). This study will investigate the diagnostic value of urinary PCA3 in PCa and its potential value in predicting PCa pathology. Methods: From July 2014 to August 2015, real-time PCR was used to detect the expression of PCA3 in 237 male urine samples, including healthy male, prostatitis (CP), benign prostatic hyperplasia (BPH) Bladder cancer and other cancer patients such as PCa. Prostate biopsy were due to digital rectal examination, serum PSA and imaging suspected PCa. For patients diagnosed with PCa, information including Gleason score and TNM stage was collected. Spearman correlation analysis was used to assess the association of PCA3 with these parameters, and ROC analysis was used to assess the predictive value of PCA3 score. Results: A total of 237 patients were enrolled, including 35 healthy men, 31 chronic prostatitis, 30 benign prostatic hyperplasia, 74 PCa, 21 renal cancer, 25 bladder cancer and 21 other urological tumors. The results showed that PCa in patients with PCa3 score was significantly higher (P <0.05), elevated grade PCa was particularly significant (t = 4.411, P <0.05). Bivariate correlation analysis showed that there was a positive correlation between PCA3 score and Gleason grade (r = 0.244, P = 0.036), but no correlation with PSA (r = -0.019, P> 0.05) . ROC analysis further showed that PCA3 score in PCa prognosis prognosis was significantly better than serum PSA. Conclusions: Urine PCA3 score may be a valuable biomarker for predicting PCa, and a higher PCA3 score correlates with PCa invasiveness.