尿激酶型纤溶酶原激活剂和纤溶酶原激活物抑制剂-1对前列腺癌的诊断价值研究

Diagnostic value of urokinase-type plasminogen activator and plasminogen activator inhibitor-1 in prostate cancer

目的探讨尿激酶型纤溶酶原激活剂(uPA)和纤溶酶原激活物抑制剂-1(PAI-1)对前列腺癌的诊断价值。方法选择前列腺癌患者72例(观察组)及同期健康体检者72例(对照组)进行研究。检测所有研究对象的uPA及PAI-1水平,并比较不同级别前列腺癌患者uPA及PAI-1水平,采用受试者工作特征(ROC)曲线对uPA及PAI-1的诊断效能进行分析。结果观察组患者uPA及PAI-1水平均明显高于对照组(P﹤0.01)。前列腺癌患者uPA及PAI-1水平均随着Gleason等级的升高而升高(P﹤0.05)。ROC曲线分析结果显示,uPA对前列腺癌的诊断截断值为0.78 ng/ml,灵敏度为86.11%,特异度为84.72%,ROC曲线下面积为0.718(95%CI=0.826~0.991,P=0.042)。PAI-1对前列腺癌的诊断截断值为9.28 ng/ml,灵敏度为87.50%,特异度为83.33%,ROC曲线下面积为0.908(95%CI=0.801~0.933,P=0.022)。结论前列腺癌患者uPA及PAI-1水平均明显高于健康人群,且其水平随前列腺癌严重程度升高而升高。uPA对前列腺癌的诊断截断值为0.78 ng/ml,PAI-1对前列腺癌的诊断截断值为9.28 ng/ml。

Objective To investigate the diagnostic value of urokinase-type plasminogen activator(uPA)and plasminogen activator inhibitor-1(PAI-1)in prostate cancer.Method Seventy-two patients with prostate cancer(study group)and 72 healthy volunteers(control group)were enrolled in the study.All subjects were tested for uPA and PAI-1 levels,which were further compared among patients with prostate cancer of differing degree,the diagnostic efficacy of uPA and PAI-1 was analyzed by receiver operating characteristic(ROC)curve.Result The levels of uPA and PAI-1 in the study group were significantly higher than those in the control group(P<0.01).The levels of uPA and PAI-1 in prostate cancer patients increased significantly as Gleason grade elevated(P<0.05).The ROC analysis showed that the diagnostic cut-off value of uPA for prostate cancer was 0.78 ng/ml,the sensitivity was 86.11%,the specificity was 84.72%,and the area under the ROC curve(AUC)was 0.718(95%CI=0.826-0.991,P=0.042).The diagnostic cut-off value of PAI-1 for prostate cancer was 9.28 ng/ml,with sensitivity being 87.50%,specificity being 83.33%,and AUC was 0.908(95%CI=0.801-0.933,P=0.022),respectively.Conclusion The levels of uPA and PAI-1 in prostate cancer patients are significantly higher than those in healthy population,and their levels increase with the severity of prostate cancer elevates.The diagnostic cutoff value of uPA for prostate cancer was 0.78 ng/ml,and the diagnostic cutoff value of PAI-1 for prostate cancer was 9.28 ng/ml.