血清miR-141联合PSA、NTx检测对前列腺癌骨转移的诊断价值

Diagnostic value of serum miR-141 combined with PSA and NTx in prostate cancer with bone metastasis

目的探究血清微小RNA-141(miR-141)联合游离前列腺特异性抗原(PSA)、Ⅰ型胶原氨基末端肽(NTx)检测对前列腺癌(PCa)骨转移的诊断价值。方法选择2015年3月至2019年6月该院收治的136例PCa患者,根据CT及MRI检查结果分为骨转移组(62例)和非骨转移组(74例),另选取体检健康者80例为对照组,采用实时定量PCR(qPCR)检测血清miR-141水平,采用酶联免疫吸附试验(ELISA)检测血清PSA、NTx水平,绘制受试者工作特征曲线,分析三者对PCa骨转移的诊断价值,采用Logistic回归进一步分析其与PCa骨转移的关系。结果骨转移组血清miR-141、PSA及NTx水平高于非骨转移组和对照组,非骨转移组高于对照组,差异均有统计学意义(P<0.05)。血清miR-141、PSA及NTx单独检测诊断PCa骨转移的曲线下面积(AUC)分别为0.840、0.763、0.820,当截断值分别为2.152、31.769 ng/mL、195.46 mg/L时,灵敏度分别为80.61%、64.52%、51.61%,特异度分别为83.78%、100.00%、100.00%。PSA、NTx二者联合检测诊断PCa骨转移的AUC为0.830,灵敏度、特异度分别为64.52%、100.00%,三者联合诊断PCa骨转移的AUC为0.946,灵敏度、特异度分别为85.48%、97.30%。Logistic回归分析结果显示,血清miR-141、PSA及NTx水平升高均是PCa骨转移发生的独立危险因素(P<0.05)。结论血清miR-141、PSA、NTx水平升高与PCa骨转移有关,三者联合检测对PCa骨转移早期诊断及病情评估的临床应用价值更高。

Objective To investigate the values of serum microRNA-141(miR-141),prostate-specific antigen(PSA)and N-terminal typeⅠcollagen telopeptide(NTx)in the diagnosis of prostate cancer(PCa)bone metastasis.Methods A total of 136 PCa patients admitted to the hospital from March 2015 to June 2019 were selected and divided into bone metastasis group(62 cases)and non-bone metastasis group(74 cases)according to the results of CT and MRI examination.In addition,serum specimens from 80 healthy subjects were collected as control group.The level of serum miR-141 was detected by real-time quantitative PCR(qPCR),the levels of serum PSA and NTx were detected by enzyme-linked immunosorbent assay(ELISA),the diagnostic value of the three in PCa bone metastasis was analyzed by receiver operating characteristic curve,and Logistic regression was used to further analyze the relationship between PCa and bone metastasis.Results Serum miR-141,PSA and NTx levels in bone metastasis group were higher than those in the non-bone metastasis group and the control group,and those in the non-bone metastasis group were higher than those in the control group,and the differences were statistically significant(P<0.05).The AUCs of serum miR-141,PSA and NTx in the diagnosis of PCa bone metastasis were 0.840,0.763 and 0.820,respectively,and when the cutoff value was 2.152,31.769 ng/mL and 195.46 g/L respectively,the sensitivity was 80.61%,64.52%,51.61%,and the specificity was 83.78%,100.00%and 100.00%,respectively.The AUC of PSA and NTx combined in the diagnosis of PCa bone metastasis was 0.830,the sensitivity and specificity were 64.52%and 100.00%,respectively,and the AUC of miR-141,PSA and NTx combined in the diagnosis of PCa bone metastasis was 0.946,the sensitivity and specificity were 85.48%and 97.30%,respectively.Logistic regression analysis showed that the increases of serum miR-141,PSA and NTx levels were independent risk factors for PCa bone metastasis(P<0.05).Conclusion The increase of serum miR-141,PSA and NTx levels is related to the bone metastasis of PCa,and the combined detection of the three has a higher clinical value in the early diagnosis and condition evaluation of PCa bone metastasis.