血清MIR-27a、tPSA、fPSA联合检测对前列腺癌的诊断价值

Diagnostic value of combined detection of serum MIR-27a,tPSA and fPSA in prostate cancer

目的通过测定人总前列腺特异度抗原(tPSA)、游离前列腺特异度抗原(fPSA)、fPSA与tPSA的比值(f/tPSA)以及miRNA-21a(MIR-27a)在健康成年男性、前列腺增生患者和前列腺癌患者血清中的水平,评估以上指标在前列腺癌早期诊断中的价值。方法收集任丘市人民医院2013年1月至2017年1月体检、门诊和住院患者589例,包括前列腺癌(Ⅰ～Ⅳ期)73例,前列腺增生219例,对照组为健康成年男性297例。所有前列腺癌均有前列腺活检穿刺病理结果,前列腺增生患者有直肠指检、影像学资料和前列腺电切术后病理结果,健康成年男性有直肠指检、影像学资料和tPSA、fPSA等检测结果。根据受试者工作特征曲线(ROC曲线)评估以上指标在前列腺癌诊断中的价值。结果前列腺增生组中,tPSA、fPSA和MIR-27a与对照组比较均明显上升,差异有统计学意义(P<0.05),f/tPSA>0.30,与对照组比较,差异有统计学意义(P>0.05);前列腺癌组tPSA、fPSA、f/tPSA和MIR-27a均较对照组和前列腺增生组显著增高,差异有统计学意义(P<0.05)。tPSA的ROC曲线下面积为0.872,最佳临界值为<4.08ng/mL,其灵敏度和特异度分别为0.899和0.875;fPSA的ROC曲线下面积为0.794,最佳临界值为<0.26ng/mL,其灵敏度和特异度分别为0.901和0.675;MIR-27a的ROC曲线下面积为0.819,最佳临界值为0.23,其灵敏度和特异度分别为0.743和0.856。结论MIR-27a、tPSA、fPSA联合检测对前列腺癌早期诊断有较高价值。

Objective To detecte the serum levels of total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),ratio of fPSA to tPSA(f/tPSA)and MIR-27a in healthy adult men,patients with benign prostatic hyperplasia and patients with prostate cancer,and to evaluate the value of these indicators in the early diagnosis of prostate cancer.Methods Totally 589 patients,including 73 cases of prostate cancer(stageⅠ-Ⅳ),219 cases of benign prostatic hyperplasia and 297 healthy adult males(as control)in Renqiu People′s Hospital from January 2013 to January 2017 were collected.All prostate cancers had pathological results of prostate biopsy.Patients with benign prostatic hyperplasia had rectal digital biopsy,imaging data and pathological results after prostatectomy.Healthy adult men had rectal digital biopsy,imaging data,tPSA,fPSA and other test results.According to the ROC curve,we evaluated the value of these indicators in the diagnosis of prostate cancer.Results Compared with the control group,the levels of tPSA,fPSA and MIR-27a in benign prostatic hyperplasia group were significantly increased(P<0.05),the ratio of f/tPSA>0.30,compared with control group,the difference statistically was significant(P>0.05).The levels of tPSA,fPSA,f/tPSA and MIR-27a in prostate cancer group were significantly changed than those in control group and benign prostatic hyperplasia group(P<0.05).The AUC of tPSA was 0.872,the optimum bound value was below 4.08 ng/mL,the sensitivity and specificity were 0.899 and 0.875,respectively;the AUC of f/tPSA was 0.794,the optimum bound value was above 0.26,the sensitivity and specificity were 0.901 and 0.675,respectively;the AUC of MIR-27a was 0.819,the optimum bound value was 0.23,the sensitivity and specificity were 0.743 and 0.856 respectively.Conclusion Combined detection of MIR-27a,tPSA and fPSA is of high value in early diagnosis of prostate cancer.