前列腺特异膜抗原mRNA的临床应用研究

Clinical Study on Detection of Prostate-specific Membrane Antigen mRNA

目的 :通过检测治疗前后的前列腺癌 (PC)病人外周血前列腺特异膜抗原信使核糖核酸 (PSMAmRNA)的表达 ,了解原发性前列腺癌的血行播散情况及为前列腺癌综合治疗提供依据。 方法 :采用巢式逆转录—聚合酶链反应 (RT PCR)检测技术 ,对 31例PC病人外周血PSMAmRNA的表达进行了研究。 结果 :31例样本中 ,17例PC病人 (5 4.8% )PSMAmRNA阳性 ,10例正常人和 2 1例良性前列腺肥大 (BPH)病人全阴性 ;10例伴远处转移的PC病人外周血PSMAmRNA全阳性 ,2 1例检测时尚无转移证据者 33.3% (7/ 2 1)阳性 ;外周血PSMAmRNA阳性率与血清PSA水平密切相关 ;根治术或姑息性治疗前、后外周血PSMAmRNA阳性率差异无显著性。 结论 :外周血PSMAmRNA检测可诊断前列腺癌血行播散及转移 ,可作为预测前列腺癌复发、转移的参考指标 ,对外周血PSMAmRNA阳性病人应在围手术期辅以激素、放疗或免疫等辅助治疗 ,以预防肿瘤复发、转移。

Objectives:To investigate the relationship between the status of hematogenous spread of prostate cancer(PC) and peripheral blood PSMA mRNA expression. [WT5”HX]Methods: [WT5”BZ]Peripheral blood samples were collected from 31 patients with PC, 22 of whom had received therapy after samples were collected again, and from 31 subjects as control (10 cases healthy donors, 21 with BPH). PSMA mRNA extracted from 5 ml whole blood was amplified by nested reverse transcription polymerase chain reaction (RT PCR). [WT5”HX]Results:[WT5”BZ]Of the 31 PC patients, 17 (54.8%) patients had positive PSMA mRNA, while PSMA mRNA wasnt detected in all of the patients with benign prostate hypertrophy (BPH) and the healthy subjects. In 10 PC patients with extra prostate metastasis, all were positive for PSMA mRNA. In patients who didnt have metastasis, 33.3% of them (7/21) gave positive PSMA mRNA. The presence of PSMA mRNA was correlated with the serum PSA level. There was no significant difference in PSMA mRNA expression before and after surgical treatment. [WT5”HX]Conclusions:[WT5”BZ]PSMA mRNA is a valuable marker for detecting hematogenous dissemination and metastasis of PC. Anti androgen therapy, radiotherapy or immunotherapy is needed to prevent clinically overt metastasis and recurrence.