新型前列腺癌标志物对PSA灰区的临床应用研究

Clinical Research of a New Prostate Cancer Biomarker for Diagnosis With PSA in Diagnostic Gray Zone

目的研究新型前列腺癌标志物PCA-M对PSA灰区患者的诊断效能。方法筛选本院2018年6月—9月行前列腺穿刺的患者41例,收集并比较PCA-M(PRKY和TGIF2LY)与PSA相关指标的诊断效能。结果病理确诊前列腺癌18例,前列腺增生23例,两组间年龄、PSA及PRKY甲基化差异无明显统计学意义(P>0.05),而DRE、MRI诊断、f/tPSA、PSAD及TGIF2LY甲基化差异有明显统计学意义(P<0.05)。TGIF2LY基因甲基化水平(75.61%)与DRE(68.29%)、MRI诊断(68.29%)、f/tPSA(73.17%)、PSAD(65.85%)的诊断符合率比较未见明显差异(P>0.05)。结论前列腺癌患者中TGIF2LY基因甲基化水平明显减少,其诊断符合率相较于其他指标有一定的参考价值,可以作为前列腺穿刺的指征之一。

Objective To investigate the diagnosis efficiency of a new prostate cancer biomarker PCA-M with PSA in diagnostic gray zone. Methods From June 2018 to September 2018,clinical data of 41 cases of prostate biopsy was collected and the methylation levels of PRKY and TGIF2LY in urine were analyzed to estimate the risk of prostate cancer. Results According to the pathological results,18 cases were diagnosed prostate and 23 cases were diagnosed benign prostate hyperplasia.Compared with benign prostate hyperplasia,there was significant difference in TGIF2LY methylation level,DRE,MRI,f/t PSA,PSAD (P < 0.05) but age,PSA and PRKY methylation level (P > 0.05).And no obvious difference was found in the diagnose accordance rate among TGIF2LY methylation level,DRE, MRI,f/t PSA,PSAD (P > 0.05).TGIF2LY methylation level was significantly decreased in prostate cancer and its diagnose accordance rate(75.61%) was higher than DRE(68.29%),MRI(68.29%),f/t PSA(73.17%),PSAD (65.85%). Conclusion The methylation level of TGIF2LY gene is significantly reduced in patients with prostate cancer,and its diagnostic coincidence rate has certain reference value compared with other indicators,which can be used as one of the indications for prostate puncture.