尿液中Zimp7早期诊断前列腺癌的潜在价值

The significance of urine-detectable Zimp7 for early diagnosis of prostate cancer

背景与目的：雄激素受体（androgen receptor，AR）辅助因子失调将激活AR并直接促进前列腺癌的发生、发展。Zimp7（human zinc finger—containing，MiZl，PIAS-1ike protein on chromosome7）是一新发现的AR辅助因子，本研究的前期工作证实，其在中国前列腺癌组织标本中高表达，预示着其可能是前列腺癌的一种特异性标志物。本研究旨在探讨尿液中Zimp7在前列腺癌早期诊断中的应用价值。方法：收集97例患者的尿液标本，其中42例前列腺癌患者，50例前列腺良性病变患者，5例膀胱癌患者。采用实时荧光定量PeR技术（real—time quantitative polymerase chain reaction，RT—PeR）检测Zimp7mRNA的表达。结果：当前列腺特异抗原（prostate specific antigen，PSA）为4-10ng／mL时Zimp7的受试者工作特征曲线下面积（AUC）为0．850（P=0．002），Zimp7阂值设定为53．00时其诊断前列腺癌的灵敏度、特异度、阳性预测值、阴性预测值分别为77．8％、84．6％、63．6％和91．7％；当不进行PSA分层时，Zimp7的AUC值为0．684（P=-0．004）；当阈值设定为17．26时，其灵敏度、特异度、阳性预测值、阴性预测值分别为66．7％、63．0％、60．5％和69．0％。另外，未发现Zimp7与年龄、pSA值和Gleason值之间有显著相关性。结论：检测尿液中Zimp7mRNA是一种无创的、可行的前列腺癌早期诊断方法。

Background and purpose： The dys-regulation of androgen receptor （AR） co-factor may activate AR and directly contribute to prostate cancer development and progression. The overexpression of Zimp7 （human zinc finger-containing, Mizl, PIAS-like protein on chromosome 7）, which had been verified as a newly discovered AR cofactor, was then detected in Chinese prostate cancer tissue in our polit experiment, suggesting that it may be a specific biomarker for prostate cancer. The purpose of this study was to investigate the value of urine Zimp7 for early diagnosis of prostate cancer. Methods： Ninety seven urine samples from 42 patients with prostate cancer were collected, 50 patients with benign lesion of prostate, 5 patients with bladder cancer were collected. The expression pattern ofZimp7 mRNA in urine was determined using real-time quantitative polymerase chain reaction method. Results： In the subgroup patients, the prostate specific antigen （PSA） level was 4-10 ng/mL, the area under the curve （AUC） of Zimp7 was 0.850 （P=-0.002）; and when the threshold of Zimp7 set as 53.00, the sensitivity, specificity, positive and negative predictive value of detecting prostate cancer were 77.8%, 84.6%, 63.6% and 91.7%, respectively. In the cohort of all patients, the AUC of Zimp7 was 0.684 （P=0.004）; and when the cutoff set as 17.26, the sensitivity, specificity, positive and negative predictive value were 66.7%, 63.0%, 60.5% and 69.0%, respectively. Additionally, non-significant correlation of Zimp7 with age, serum PSA, and biopsy Gleason score were found in both population. Conclusion： Detecting urine Zimp7 mRNA is one of non-invasive, feasible and potential methods for early diagnosis of prostate cancer.