血清p2PSA联合细胞因子对PSA灰区前列腺癌患者的诊断价值

The diagnostic significance of serum p2PSA with cytokines for patients with prostate cancer:PSA in grey area

目的:研究前列腺特异性抗原同源异构体2(p2PSA)、百分比p2PSA(%p2PSA)、前列腺健康指数(PHI)、细胞因子6(IL-6)、肿瘤坏死因子(TNF-ɑ)和辅助性T细胞17(Th17)相关因子对血清PSA灰区(4~10μg/L)前列腺癌的诊断价值。方法:选择血清PSA为4~10μg/L、直肠指诊(-)并接受前列腺穿刺活检的60例老年男性患者,根据病理结果将其分为前列腺癌(PCa)组(37例)和良性前列腺增生(BPH)组(23例);另选同期进行体检的30名健康男性纳入健康对照组。以病理结果为金标准,采用受试者工作特征(ROC)曲线比较各标志物在PCa中的诊断效能。结果:PCa组与BPH组患者仅p2PSA、%p2PSA和PHI比较差异具有统计学意义(U=2.410、U=3.491、U=4.213;P<0.05),3项指标均对前列腺癌诊断具有较高的准确性,ROC曲线下面积(AUC)分别为0.691、0.834和0.777。BPH组与健康对照组相比,IL-6、TNF-ɑ差异均有统计学意义(U=3.943,U=3.513;P<0.05),PCa组与健康对照组相比,IL-6、TNF-ɑ、IL-17A和IL-36γ差异均有统计学意义(U=4.363,U=3.152,U=2.210,U=3.077;P<0.05),但PCa组和BPH组各项细胞因子差异无统计学意义。结论:p2PSA、%p2PSA和PHI能进一步提高PSA在4~10μg/L时患者的前列腺癌诊断准确性,且具有更高的肿瘤特异性,将成为更好的前列腺癌辅助诊断新指标。

Objective:To investigate the diagnostic value of isoform[-2]pro-prostate specific antigen(p2 PSA),percentage of p2 PSA(%p2 PSA),prostate health index(PHI),Interleukin-6(IL-6),tumor necrosis factor-ɑ(TNF-ɑ)and T helper cell 17(Th17)related cytokines in prostate cancer detection which serum prostate specific antigen(PSA)level(4-10μg/L)was in grey area.Methods:60 elderly male patients,whose serum PSA were 4-10μg/L and digital rectal examination were(-)and who underwent prostate biopsy,were selected.According to the pathological results,these patients were divided into prostate cancer(PCa)group(37 cases)and benign prostatic hyperplasia(BPH)group(23 cases).Another 30 healthy males who underwent physical examination at the same time were divided into the healthy control group.The pathological results were used as the gold standard,and the diagnostic efficacies of various markers in PCa were compared by adopting receiver operating characteristic(ROC)curves.Results:There were statistically significant differences in p2 PSA,%p2 PSA and PHI between PCa group and BPH group(U=2.410,U=3.491,U=4.213,P<0.05).And the three indexes had higher accuracy in the diagnosis for PCa,and the area under curves(AUC)of them were 0.691,0.834 and 0.777,respectively.There were significant differences in IL-6 and TNF-ɑbetween BPH group and healthy control group(U=3.943,U=3.513,P<0.05).There were significant differences in IL-6,TNF-ɑ,IL-17 A and IL-36γbetween PCa group and healthy control group(U=4.363,U=3.152,U=2.210,U=3.077,P<0.05).But there was no significant difference in each kind of cytokines between PCa group and BPH group.Conclusion:p2 PSA,%p2 PSA and PHI can further improve the diagnostic accuracy of prostate cancer in patients whose PSA are in grey area(4-10μg/L).And they have higher tumor specificity,and they will be better new indicators of auxiliary diagnosis for prostate cancer.