前列腺癌患者血清PSA-SLe~X的表达及意义

发布时间：2018-05-19 12:47

本文选题：前列腺癌 + 前列腺增生　；参考：《河北大学》2017年硕士论文

【摘要】：目的:应用荧光探针SLeX(Sialyl-Lewis X,唾液酸化的路易斯寡糖-X抗原)检测血清样本,建立前列腺癌诊断新方法,提高前列癌的早期诊断率。探讨荧光探针SLeX在前列腺癌诊断中的应用的价值及在临床TNM分期、病理分级及Gleason评分中的意义。方法:选取2015年1月～2016年12月河北大学附属医院泌尿外科住院患者76例,其中前列腺增生患者38例(BPH组)、前列腺癌患者38例(PCa组),两组均由前列腺穿刺或/和术后病理诊断。前列腺癌组按2002年美国癌症联合会(AJCC)TNM分期分为局限性组(T1、T2期)16例和非局限组(T3、T4期)22例;按Gleason评分(2～4分属高分化癌;5～7分为中分化癌;8～10分为低分化癌)分为高分化癌、中分化癌、低分化癌分别为12例、10例、16例。以荧光探针SLeX作为检测抗体,应用ELISA法(酶联免疫吸附)检测血清中PSA-SLeX(前列腺特异性唾液酸化的路易斯寡糖-X抗原)的表达含量,与我院检验科现行的双位点酶免法检测血清方法(双抗体夹心法)检测血清TPSA表达含量,比较分析两种检测方法在前列腺癌诊断中的应用的价值及在临床TNM分期、病理分级及Gleason评分中的意义的可行性及意义。结果:1.PSA-SLeX在前列腺癌与前列腺增生中均有表达,但在前列腺癌中呈高表达水平,两者之间表达量有显著差异(P=0.000)。2.应用ROC曲线可以得出,PSA-SLeX与TPSA的曲线下面积(AUC)分别为0.851和0.815;荧光探针SLeX与在TPSA前列腺癌中的诊断价值相当(P0.05)。血清PSA-SLeX与TPSA在前列腺癌实验中诊断最佳临界值(即cutoff值)分别为13.15ng/ml和 9.68ng/ml。3.前列腺癌TNM分期中,非局限组中PSA-SLeX表达浓度较TPSA浓度高,差异有统计学意义(P=0.001)。4.前列腺癌Gleason评分分组中,在中、低分化前列腺癌组间血清中PSA-SLeX表达浓度较TPSA要高,比较差异有统计学意义(P0.05)。结论:荧光探针SLeX用于临床前列腺癌的筛查时,在前列腺癌TNM分期的中晚期及Gleason评分分组的中、低分化的阳性检出率优于TPSA的阳性检出率。
[Abstract]:Objective: to establish a new method for the diagnosis of prostate cancer by using fluorescent probe SLeX(Sialyl-Lewis X, salivary acidified Lewis oligosaccharide X antigen to detect serum samples, and to improve the early diagnosis rate of prostatic carcinoma. To evaluate the value of fluorescent probe SLeX in the diagnosis of prostate cancer and its significance in clinical TNM staging, pathological grading and Gleason score. Methods: from January 2015 to December 2016, 76 patients in urology department of affiliated Hospital of Hebei University were selected, including 38 patients with benign prostatic hyperplasia (BPH) and 38 patients with prostate cancer (group PCA). Both groups were diagnosed by prostate puncture or / and postoperative pathology. According to the 2002 AJCC TNM staging, prostate cancer patients were divided into two groups: localized group (n = 16) and nonlocalized group (n = 22). According to the Gleason score, they were classified as well-differentiated carcinoma and poorly differentiated carcinoma, respectively. There were 12 cases of poorly differentiated carcinoma, 10 cases of carcinoma and 16 cases of carcinoma. The expression of PSA-SLeX (prostate-specific saliva acidified Lewis oligosaccharide X antigen) in serum was detected by using fluorescent probe SLeX as antibody and ELISA assay (enzyme-linked immunosorbent assay). The expression of TPSA in serum was detected by double antibody sandwich method, and the value of the two detection methods in the diagnosis of prostate cancer and the clinical TNM staging were compared and analyzed. The feasibility and significance of pathological grading and Gleason score. Results 1. PSA-SLeX was expressed in both prostate cancer and prostatic hyperplasia, but it was highly expressed in prostate cancer. There was a significant difference in the expression of PSA-SLeX between the two groups. The area under the curve of PSA-SLeX and TPSA was 0.851 and 0.815 respectively by using ROC curve. The diagnostic value of fluorescence probe SLeX was similar to that of TPSA in the diagnosis of prostate cancer. The best critical value (cutoff value) for serum PSA-SLeX and TPSA in prostate cancer test was 13.15ng/ml and 9.68 ng / ml. 3 respectively. In the TNM stage of prostate cancer, the PSA-SLeX expression level in the non-localized group was higher than that in the TPSA group, and the difference was statistically significant. In the Gleason score group of prostate cancer, the expression of PSA-SLeX in the serum of low differentiated prostate cancer patients was higher than that of TPSA, and the difference was statistically significant (P 0.05). Conclusion: when the fluorescent probe SLeX is used in clinical prostate cancer screening, the positive rate of low differentiation is better than that of TPSA in the middle and late stages of TNM stage and in the Gleason score group of prostate cancer.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.25

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