游离循环DNA以及联合应用直肠指诊和经直肠超声检查诊断前列腺癌的临床价值

Diagnostic value of digital rectal examination,free circulating DNA and transrectal ultrasound method for prostate cancer

目的探讨游离循环DNA(cf-DNA)以及联合应用直肠指诊(DRE)和经直肠超声(TRUS)检查对前列腺癌的诊断价值。方法对93例可疑前列腺癌患者进行DRE、cf-DNA、TRUS检查并与术后病理结果对照,比较三种检查方法单独应用、两者联合应用及三者联合应用对前列腺癌的诊断价值。结果前列腺癌、前列腺良性病变和对照组血清cf-DNA的浓度分别是中位数1223.2ng/ml、153.2ng/ml和118.3ng/ml,三者依次减低,差异有统计学意义(P<0.001);cf-DNA+TRUS+DRE的联合检测方法的敏感性为90.6%,均高于cf-DNA、TRUS和DRE,差异有统计学意义(P<0.05);联合检测特异性也高于cf-DNA、TRUS和DRE,差异有统计学意义(P<0.05),但与TRUS特异性差异无统计学意义(P>0.05)。结论联合应用DRE、cf-DNA、TRUS对提高前列腺癌的诊断具有重要临床价值。

Objective To investigate the diagnostic value of free circulating DNA （cf-DNA） and its combination with digital rectal examination （DRE）, and transrectal ultrasound （TRUS） method for prostate cancer. Methods Ninty-three suspected patients of prostate cancer were all examined by DRE, cf-DNA and TRUS. The diagnostic value of the three methods alone, combination of the two and the combination diagnosis of the three were evaluated. Results The median concentration for prostate cancer group, non-prostate cancer group and healthy control group were 1223.2 ng/ml, 153.2 ng/ml and 118.3 ng/ml. There was significant difference among the three groups （P 〈 0.001 ）. The sensitivity for combined method of cf-DNA,TRUS and DRE was 90.6%, which was higher than that of cf-DNA, TRUS or DRE alone, which was statistically significant（P 〈 0.05） ; the specificity of combined detection was also higher than that of cf-DNA and DRE, which was also significant （P 〈 0.05）, but not for TRUS. Conclusion The combined application of digital rectal examination, cf-DNA and transrectal ultrasonography is clinically important for prostate cancer diagnosis.