PCA3检测在PSA灰区对前列腺癌诊断及病理分级的价值

发布时间：2018-03-29 14:12

本文选题：前列腺癌抗原3　切入点：前列腺癌　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:研究外周血前列腺癌抗原3(PCA3)在前列腺特异性抗原(PSA)灰区(4-10ng/ml)时对前列腺癌的诊断价值;通过测定PCA3在前列腺癌不同病理分级患者中的表达量研究其与前列腺癌病理分级(分化程度)的关系。方法:随机选取2016年4月至2016年12月间山西医科大学第一医院泌尿外科住院的前列腺癌患者30例作为试验组,另选取良性前列腺增生患者34例作为对照组,并且其血PSA均为4-10ng/ml。采用实时荧光PCR技术检测两组外周血单个核细胞中PCA3 m RNA相对表达量,并统计前列腺癌组PCA3 m RNA相对表达量与高分化(Gleason评分2-4分)、中分化(Gleason评分5-6分)、低分化(Gleason评分7-10分)前列腺癌的关系。结果:在64例受试者中,30例经病理诊断为前列腺癌,其PCA3的相对表达量为2.50±1.79;34例为良性前列腺增生,其PCA3的相对表达量为1.01±0.54,P0.05,差异有统计学意义。表明PCA3 m RNA高表达于前列腺癌患者血液,在良性前列腺增生患者中低表达。30例前列腺癌患者中,8例Gleason评分为7-10分,其PCA3的相对表达量为4.40±2.27;17例Gleason评分为5-6分,其PCA3的相对表达量为2.13±0.76;5例Gleason评分为2-4分,其PCA3的相对表达量为0.72±0.28,三组之间两两相比差异均有统计学意义,表明低分化组前列腺癌患者PCA3 m RNA相对表达量高于中分化组及高分化组前列腺癌的患者,中分化组前列腺癌患者PCA3 m RNA相对表达量高于高分化组前列腺癌的患者。结论:在PSA处于灰区的患者中,PCA3 m RNA相对表达量越高,患前列腺癌可能性越大,可为前列腺癌筛查提供参考,穿刺活检阳性率高;在PSA处于灰区的前列腺癌患者中,PCA3 m RNA相对表达量越高,前列腺癌病理分级越高,前列腺癌细胞恶性程度越大,分化程度越低,提示预后较差。
[Abstract]:Objective: to study the diagnostic value of peripheral blood prostate cancer antigen (PCA3) in the prostate specific antigen (PSA) gray region (4-10 ng / ml). The relationship between the expression of PCA3 and the pathological grade (differentiation) of prostate cancer was studied by measuring the expression of PCA3 in patients with different pathological grades of prostate cancer. Methods: the first one of Shanxi Medical University from April 2016 to December 2016 was randomly selected. Thirty patients with prostate cancer in urology department were treated as trial group. 34 patients with benign prostatic hyperplasia (BPH) were selected as control group and their blood PSA was 4-10 ng / ml. The relative expression of PCA3 m RNA in peripheral blood mononuclear cells was detected by real-time fluorescent PCR technique. The relationship between the relative expression of PCA3 m RNA and Gleason score 2-4, Gleason score 5-6, Gleason score 7-10) was analyzed. Results: 30 of 64 subjects were pathologically diagnosed as prostate cancer. The relative expression of PCA3 was 2.50 卤1.79m in 34 patients with benign prostatic hyperplasia, and the relative expression of PCA3 was 1.01 卤0.54g P0.05.The results showed that PCA3 m RNA was highly expressed in the blood of patients with prostate cancer. The Gleason score was 7-10 in 8 patients with benign prostatic hyperplasia, the relative expression of PCA3 was 5-6 in 17 patients with Gleason, and the relative expression of PCA3 was 2.13 卤0.760.The Gleason score was 2-4 in 5 patients with benign prostatic hyperplasia. The relative expression of PCA3 was 0.72 卤0.28, the difference between the three groups was statistically significant, which indicated that the relative expression of PCA3 m RNA in the low differentiated prostate cancer patients was higher than that in the moderately differentiated prostate cancer patients and the well-differentiated prostate cancer patients. The relative expression of PCA3 m RNA in moderately differentiated prostate cancer patients was higher than that in well differentiated prostate cancer patients. Conclusion: the higher the relative expression of PCA3 m RNA in patients with PSA in gray zone, the more likely it is to develop prostate cancer. The higher the relative expression of PCA3 m RNA, the higher the pathological grade of prostate cancer, and the greater the malignant degree of prostate cancer cells, the higher the positive rate of puncture biopsy in prostate cancer screening, the higher the relative expression of PCA3 m RNA in prostate cancer patients in the gray area of PSA, and the higher the pathological grade of prostate cancer is. The lower the degree of differentiation, the worse the prognosis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.25

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