MALAT-1联合PSA检测对前列腺癌的诊断价值

Diagnosis value of MALAT-1 combined with PSA in detection of prostate cancer

目的:检测前列腺癌患者血清肺腺癌转移相关转录因子-1(MALAT-1)表达,探讨其对前列腺癌的诊断价值。方法:选择85例前列腺癌患者(癌变组)、68例良性前列腺增生患者(良性组)和50例男性健康体检者(对照组)作为研究对象,于术前、术后3 d、术后7 d采集癌变组和良性组患者空腹肘静脉血,于体检时采集对照组体检者空腹时静脉血;实时定量PCR检测血清MALAT-1表达,分析血清MALAT-1表达与前列腺癌患者临床参数的关系及其诊断价值。结果:癌变组血清MALAT-1相对表达量明显高于良性组和对照组,差异有统计学意义(P<0.01),但良性组和对照组血清MALAT-1相对表达差异无统计学意义(P>0.05)。与术前比较,良性组术后3 d、术后7 d血清MALAT-1表达无明显变化(P>0.05);癌变组术后3 d血清MALAT-1相对表达较术前明显升高,差异有统计学意义(P<0.01)。临床分期>T2a组血清MALAT-1表达明显高于临床分期≤T2a组(P<0.001);Gleason评分>7分组血清MALAT-1表达明显高于Gleason评分≤7分组(P<0.001);骨转移组血清MALAT-1表达明显高于无转移组(P<0.001)。血清MALAT-1表达与年龄、前列腺特异性抗原(PSA)浓度无关(P>0.05)。联合使用MALAT-1和PSA诊断前列腺癌的曲线下面积(0.865)高于单独使用MALAT-1(0.759)或PSA(0.800);MALAT-1诊断PSA阴性(≤4 ng·ml-1)前列腺癌的曲线下面积为0.747(95%置信区间为0.650~0.829),特异性为76.4%,敏感性为66.2%。结论:MALAT-1在前列腺癌中具有良好的诊断价值,可以作为前列腺癌非侵入性诊断的分子标志物。

Objective： To explore the expression of serum MALAT-1 in prostate cancer patients and its diagnostic value. Methods： A total of eighty-five prostate cancer patients, sixty-eight benign prostatic hyperplasia and fifty male healthy person were selected as cancer group, benign group and control group, respectively, the vein blood in the cancer group and the benign group was collected at pre-operation, 3-day post-operation and 7-day post- operation, respectively. Meanwhile, same volume of vein blood was collected in the control group. The serum levels of MALAT-1 was detected by quantitative real-time PCR, the correlation between MALAT-1 and patients clinical parameters, as well as its diagnostic, value were analyzed. Results： The expression of serum MALAT-1 in the cancer group was significantly higher than in the benign group and the control group （P 〈0.01 ）, however, therewas no significant difference between the benign group and the control group （P 〉 0.05）. Compared with pre- operation, there were no changes of MALAT- 1 expression at 3- day and 7- day post- operation in the benign group （P 〉 0. 05 ） , but at 3- day post- operation, the expression of MALAT- 1 was obviously increased in the cancer group when compared to the pre-operation （P 〈 0.01 ）. The expression of MALAT-1 in the T2a group was significantly higher than in the T2a group （P 〈0. 001 ）, the expression of MALAT-1 in the group Gleason scores 〉7 was significantly higher than in the group Gleason scores ≤7 （P 〈 0. 001 ） , the expression of MALAT-1 in the bone metastases group was significantly higher than that in the without bone metastases group （ P 〈 0. 001 ）, there was no significant correlation between MALAT- 1 and age, PSA （P 〉 0. 05）. The area under curve of combined diagnostic of MALAT- 1 and PSA （0. 865） was higher than single MALAT- 1 （0. 759） or PSA （0.800）. The AUC of MALAT- 1 for PSA-negtive prostate cancer was 0. 747 （95% CI： 0. 650 -0. 829） , and the specificity and sensitivity were 76.4% and 66.2%, respectively. Conclusion ： MALAT- 1 has a good diagnostic value and can be used as a new non-invasive biomarker for the diagnosis of prostate cancer.