血清骨膜素联合PSA检测对前列腺癌的诊断价值分析

Analysis of diagnostic value of serum periostin combined with prostate specific antigen in prostate cancer

目的 探讨血清骨膜素（periostin,PN）联合前列腺特异度抗原（prostate specific antigen,PSA）检测对前列腺癌（prostate cancer,PCa）的诊断价值.方法 纳入90例PCa患者为PCa组,50例良性前列腺增生症（benign prostatic hyperplasia,BPH）患者为BPH组,30例健康体检者为正常对照组;采用酶联免疫吸附测定法（ELISA）检测血清PN水平;采用化学发光法检测PSA水平;分析PN与前列腺癌临床病理特征之间的关系,通过受试者工作特征（ROC）曲线分析PN联合PSA检测对前列腺癌的诊断价值.结果 PCa组患者血清PN、PSA水平均明显高于BPH组和对照组（P〈0.01）,BPH组血清PN、PSA水平均明显高于对照组（P〈0.01）.相关分析显示血清PN与PSA水平呈正相关（r=0.420,P=0.000）;不同PSA表达水平、Gleason评分、临床分期、有无远处转移的前列腺癌患者血清PN水平之间差异有统计学意义（P〈0.05或0.01）;血清PN的ROC曲线下面积（AUC）为0.914 （95％ CI：0.871 -0.957,P=0.000）,当PN的截断值为22.60,其灵敏度为93.30％,特异性为70％;血清PSA的AUC为0.818（95％ CI：0.756 -0.879,P=0.000）,当PSA的截断值为18.95,其灵敏度为75.60％,特异性为67.50％;血清PN和PSA联合检测的AUC为0.926（95％ CI：0.888 -0.964,P=0.000）,其灵敏度为83.33％,特异性为91.25％.结论 前列腺癌患者血清PN水平增高,与PSA水平呈正相关,参与了肿瘤的侵袭,血清PN可能是一个潜在的前列腺癌血清标志物.PN和PSA联合检测有助于前列腺癌的早期诊断.

Objective To investigate the diagnostic value of periostin （PN） combined with prostate specific antigen （PSA） in prostate cancer （PCa）.Methods A total of 90 patients with PCa were enrolled as PCa group in this study.Fifty patients with benign prostatic hyperplasia （BPH） were enrolled as BPH group and 30 healthy subjects were enrolled as normal control group.The level of serum PN was detected by enzyme-linked immunosorbent assay （ELISA）.The level of serum PSA was measured by chemiluminescence.The relationship between PN and the clinicopathological features of prostate cancer were analyzed.The diagnostic value of PN combined with PSA in prostate cancer was analyzed by the receiver operating profile （ROC） curve.Results The levels of serum PN and PSA in PCa group were higher than those in control group and BPH group （P 〈 0.01）.The levels of serum PN and PSA in BPH group were higher than those in control group （P 〈 0.05）.Correlation analysis showed a positive correlation between serum PN and PSA levels （r =0.420,P =0.000）.The levels of serum PN in the patients with PCa at different PSA levels,Gleason score,clinical stage,and distant metastasis were statistically significant （P 〈 0.05 or 0.01）.The area under the ROC curve （AUC） of serum PN was 0.914 （95%CI：0.871 -0.957,P =0.000）.When cutoff value of PN was 22.60,the sensitivity was 93.3% and the specificity was 70%.The AUC of PSA was 0.818 （95% CI：0.756-0.879,P =0.000）.When the cutoff value of PSA was 18.95,the sensitivity was 75.6% and the specificity was 67.5%.The AUC of PN and PSA was 0.926 （95% CI：0.888 -0.964,P =0.000）,the sensitivity was 83.33% and the specificity was 91.25%.Conclusions Serum PN levels in the patients with prostate cancer are significantly higher,and positively correlated with PSA levels,which participated in tumor invasion.Serum PN may be a potential serum marker for the diagnosis of prostate cancer.Combined detection of PN and PSA contributes to the early diagnosis of prostate cancer.