前列腺按摩后尿液DD3 mRNA的定量检测及临床应用评价

DD3 mRNA quantitative analysis in urine for the diagnosis of prostate cancer

目的探讨前列腺按摩后尿液 DD3(differential display code3,DD3)基因 mRNA 含量在前列腺癌诊断中应用价值。方法收集前列腺癌(Pca)患者21例、良性前列腺增生(BPH)40例,在前列腺穿刺活检前收集前列腺按摩后的尿液,离心取细胞沉淀物,用实时荧光定量 RT-PCR 方法检测DD3 mRNA 和 PSA mRNA 含量,以 DD3 mRNA/PSA mRNA 比值表示尿液 DD3 mRNA 含量。用受试者工作曲线(ROC)评价尿 DD3 mRNA 对 PCa 的诊断价值。分析尿液 DD3 mRNA 阳性率与临床分期和病理分级的相关性。对 DD3mRNA PCR 产物进行测序分析。结果 DD3 mRNA PCR 扩增产物经测序分析证实为 DD3 mRNA 特异度片段。PCa 组尿液 DD3 mRNA 含量明显高于 BPH 组,差异具有统计学意义(P<0.05)。尿液 DD3 mRNA 诊断 PCa 的 ROC 曲线下面积(AUC)为0.705(95%CI:0.578～0.832),以 DD3 mRNA/PSA mRNA 比值0.116为截断值时,其敏感度和特异度为66.7%和80.0%。尿液DD3 mRNA的阳性率与临床分期和病理分级无关。结论尿 DD3 mRNA 检测对前列腺癌诊断具有较高特异度和敏感度,作为 Pca 早期诊断指标具有良好的应用前景。

Objectives To investigate the clinical utility of the detection of DD3 mRNA in urine after prostate massage. Methods DD3 mRNA and PSA mRNA were measured by a real-time fluorescent quantitative reverse transcription polymerase chain reaction （FQ-RT-PCR） based on Taqman technique in Urine samples of 21 PCa and 40 BPH patients after prostate massage. PSA mRNA was used to normalize the number of prostate cells and DD3 mRNA/PSA mRNA ratio was then used as a diagnostic marker for prostate cancer. The diagnostic efficacy of DD3 mRNA in urine samples was evaluated by the ROC curve. Correlations of DD3 mRNA with different clinical and pathological parameters were analyzed. Results The DD3 mRNA expression in PCa group was significantly higher than that in the BPH group （P 〈 0. 05 ）. The AUC of DD3 mRNA/PSA mRNA ratio was 0. 705 （95%CI：0. 578 -0. 832）. The diagnostic sensitivity and specificity of DD3 mRNA/PSA mRNA ratio were 66.7% and 80. 0% at a cutoff 0. 116. The positive rate of urine DD3 mRNA was not correlated with clinical and pathological parameters. Conclusions Urine DD3 mRNA closely correlate with the presence of prostate cancer and may potentially be used in the early diagnosis of prostate cancer.