尿液PCA3评分在前列腺超声引导穿刺患者中的诊断作用

发布时间：2018-05-09 22:31

本文选题：前列腺癌 + 尿液PCA评分　；参考：《军事医学》2017年01期

【摘要】：目的探讨尿液前列腺癌抗原3(PCA3)评分在前列腺超声引导穿刺患者中的诊断作用。方法于2010年1月至2012年12月,收集248例在南京医科大学附属无锡第二医院行前列腺超声引导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PCA3 mRNA和PSA mRNA的表达。计算PCA3评分,通过ROC曲线评价PCA3评分在前列腺超声引导穿刺中的预测作用并与血清PSA进行比较。结果在248例患者中,穿刺阳性80例,穿刺阴性168例,前列腺超声引导穿刺阳性率为32.3%。前列腺穿刺阳性患者PCA3评分明显高于穿刺阴性患者(P0.001)。经ROC曲线分析,血清总PSA、PCA3评分和两者合用的曲线下面积分别为0.620、0.693和0.724。PCA3评分截断值为90.2456时,其诊断敏感性为67.5%,特异性为61.9%。PCA3评分与血清总PSA诊断价值比较,差异无统计学意义(P=0.160),但两者合用优于单用血清总PSA(P=0.011)。此外,联合前列腺癌多种危险因素和PCA3评分的前列腺癌综合诊断模型可进一步提高前列腺癌预测的准确性。结论 PCA3评分在前列腺超声引导穿刺患者中有良好的预测作用,前列腺癌综合诊断模型可提高前列腺癌预测的准确性。该研究结果需全国多中心、大样本研究进一步验证。
[Abstract]:Objective to evaluate the diagnostic value of urine prostate cancer antigen 3 (PCA 3) score in patients with prostate cancer guided by ultrasound. Methods from January 2010 to December 2012, 248 patients with prostate massage after prostate massage were collected in Wuxi second Hospital of Nanjing Medical University. The expression of PCA3 mRNA and PSA mRNA in urine sediment was detected by real time quantitative PCR. PCA3 score was calculated and the predictive effect of PCA3 score on ultrasound guided puncture of prostate was evaluated by ROC curve and compared with serum PSA. Results among 248 patients, 80 cases were positive for puncture and 168 cases were negative for puncture. The positive rate of ultrasound guided puncture of prostate was 32.3%. The PCA3 score of the patients with positive prostate puncture was significantly higher than that of the patients with negative puncture (P 0.001). By ROC curve analysis, the diagnostic sensitivity of total serum PSA-PCA3 score and the area under the combined curve were 0.620 and 0.693 and the truncation value of 0.724.PCA3 score was 90.2456, respectively. The diagnostic sensitivity was 67.5 and the specificity of 61.9%.PCA3 score was compared with the diagnostic value of serum total PSA. The difference was not statistically significant (P = 0.160), but the combination of the two groups was superior to the total serum PSA-P0. 011 (P < 0. 011). In addition, the comprehensive diagnosis model of prostate cancer combined with multiple risk factors and PCA3 score can further improve the accuracy of prostate cancer prediction. Conclusion PCA3 score is a good predictor for prostate cancer guided by ultrasound. The comprehensive diagnosis model of prostate cancer can improve the accuracy of prostate cancer prediction. The results of this study need to be further verified by multi-center and large sample studies.
【作者单位】：海军总医院超声医学科;南京医科大学附属无锡第二医院泌尿外科;
【分类号】：R737.25;R445.1

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