ERG相关融合基因在前列腺癌早期诊断中的应用

Application of E26-related gene in the early diagnosis of prostate cancer

目的探讨E26(E-Twenty six,ETS)相关融合基因(ETS-related gene,ERG)在前列腺癌早期诊断与淋巴结转移预测中的应用价值。方法选择2010年5月至2016年5月深圳市宝安区中心医院收治的怀疑为前列腺癌而接受前列腺活检的67例患者为研究对象。所有患者均进行ERG相关融合基因表达检测和组织病理学检查,分析影响前列腺癌发生以及淋巴结转移的危险因素。结果 67例患者中,59例患者经过组织病理学检查明确为前列腺癌,8例患者经过组织病理学检查明确为前列腺良性病变。从59例前列腺癌患者中随机抽取8例,与8例确诊为前列腺良性病变者共同测定ERG相关融合基因表达情况。其中,前列腺癌组ERG相关融合基因阳性表达率为75.0%,前列腺良性病变组ERG相关融合基因阳性表达率为25.0%,其差异具有统计学意义(P<0.05);单因素分析显示,患者年龄、前列腺特异性抗原(prostate cancer specific antigen,PSA)水平、PSA速率、ERG相关融合基因是导致前列腺癌发生的高危因素(P<0.05);多因素回归分析显示,PSA速率和ERG相关融合基因是导致前列腺癌发生的独立危险因素(P<0.05);59例前列腺癌患者均进行手术治疗,术中发现淋巴结转移27例,非淋巴结转移32例,前列腺癌淋巴结转移诊断的ERG相关融合基因畸变率阈值为2.6%,ERG相关融合基因诊断前列腺癌淋巴结转移的ROC曲线下面积为0.820,高于PSA的ROC曲线下面积0.718,ERG相关融合基因诊断前列腺癌淋巴结转移的效能显著优于PSA(P<0.05)。结论 ERG相关融合基因阳性表达可以作为前列腺癌发生的辅助评估工具,且对前列腺癌淋巴结转移具有预测价值。

ObjectiveTo investigate the effect of E26-related gene (ERG) in the early diagnosis of prostate cancer and the prediction of lymph node metastasis. Method67 suspected patients underwent prostate biopsy in Baoan District Central Hospital from May 2010 to May 2016 were selected. All the patients underwent detection of the expression of ERG and histopathological examination to analyze the risk factors of lymph node metastasis and prostate cancer. ResultsAmong the 67 suspected patients, 59 ones were confirmed with prostate cancer and 8 cases were confirmed with benign prostatic lesions by histopathological examination. Another 8 cases were randomly selected from the 59 patients with prostate cancer to detect the expression of ERG together with the 8 cases with benign prostatic lesions. The positive expression rate of ERG in prostate cancer group (75.0%) was higher than that in the benign prostatic lesion group (25.0%), with statistically significant difference (P<0.05). According to univariate analysis, age, prostate specific antigen (PSA) level, PSA rate and ERG were all the risk factors for prostate cancer (P<0.05). According to multivariate regression analysis, PSA rate and ERG were independent risk factors for prostate cancer (P<0.05). All the 59 patients with prostate cancer underwent surgical treatment, where lymph node metastasis was found in 27 cases. The aberration rate threshold of ERG was 2.6% and the area under the ROC curve was 0.820, larger than that of the PSA (0.718), with statistically significant difference (P<0.05). ConclusionsThe positive expression of ERG can serve as an auxiliary assessment tool of prostate cancer, which is also of predictive value for lymph node metastasis.