PSMA和PSA在前列腺癌早期诊断中的价值

Diagnostic value of PSMA and PSA for prostate cancer

目的探讨前列腺特异性膜抗原(PSMA)、前列腺特异性抗原(PSA)对前列腺癌的诊断价值。方法将76例前列腺癌患者、31例前列腺炎分别作为前列腺癌组和前列腺炎组,同时将35例健康体检者作为对照组。采用酶联免疫吸附测定(ELISA)检测3组受试者血清PSMA和PSA水平;采用蛋白质印迹法(Western blot)检测3组受试者PSMA和PSA蛋白阳性表达率;比较不同Gleason评分和不同分化程度前列腺癌患者前列腺癌组织中PSMA和PSA蛋白的相对表达量。相关性分析采用Pearson相关分析。结果前列腺癌组患者血清PSA和PSMA水平和阳性表达率均高于对照组受试者和前列腺炎组患者,差异均有统计学意义(P﹤0.05)。随着Gleason评分的增高,前列腺癌患者前列腺癌组织PSMA蛋白的相对表达量逐渐升高,差异均有统计学意义(P﹤0.05),而PSA蛋白的相对表达量无明显变化,差异均无统计学意义(P﹥0.05)。Pearson相关分析显示,Gleason评分与PSMA的表达呈正相关(r=0.869,P﹤0.01),与PSA蛋白的表达无相关性(r=0.235,P﹥0.05)。分化程度差的前列腺癌患者的PSMA蛋白的相对表达量高于分化良好/中等的患者,差异有统计学意义(P﹤0.05)。结论PSMA在前列腺癌的早期诊断、治疗、病情评估方面具有较高实用价值,可作为前列腺癌早期诊断的特异性标志物,具有一定的临床意义。

Objective To investigate the diagnostic value of prostate-specific membrane antigen(PSMA)and prostate specific antigen(PSA)for prostate cancer.Method The analysis had included 76 cases of prostatic cancer as prostate cancer group,and 31 cases with prostatitis as prostatitis group,besides,another 35 cases of healthy volunteers were enrolled as control group.Enzyme-linked immunosorbent assay(ELISA)was performed to detect the PSMA and PSA serum levels in all three groups of patients;Western blot was used to detect the positive expression rate of PSMA and PSA in three groups of subjects;additionally,the relative expression of PSMA and PSA proteins in prostate cancer tissues of prostate cancer patients with differing Gleason scores were compared.Correlation analysis was conducted using Pearson method.Result Serum PSA and PSMA levels and their positive expression rates in patients with prostate cancer were significantly higher than those in the prostatitis group and control group(P<0.05).Higher relative expression of PSMA proteins in prostate cancer tissues was noted as the Gleason score increased among prostate cancer patients,with statistically significant differences observed(P<0.05),while no similar trend was observed for PSA protein expression(P>0.05).Pearson correlation coefficient analysis showed that the Gleason score was positively correlated with relative expression of PSMA protein(r=0.869,P<0.01),while was not associated with that of PSA protein(r=0.235,P>0.05).In prostate cancer patients,the relative expression of PSMA protein in poorly differentiated lesions was significantly higher than that in highly/moderately differentiated ones,indicating statistically significant difference(P<0.05).Conclusion PSMA is evidently conducive to the early diagnosis,treatment,and disease evaluation,demonstrating the potential to be a specific marker for early diagnosis of prostate cancer,with promising clinical significance.