尿miR-128a和miR-28-3p联合检测在前列腺癌诊断和预后中的价值

The application value of combined detection of urine miR-128a and miR-28-3p in diagnosis and prognosis assessment of prostate cancer

目的观察联合检测尿液miR-128a和miR-28-3p水平在前列腺癌诊断和预后中的价值。方法选择2013年1月至2016年12月确诊的前列腺癌患者尿液标本117例,为前列腺癌组。选择同期诊断为前列腺良性增生(75例)和健康体检者(30例)的尿液标本,分别为前列腺良性增生组和健康对照组。采用定量RT-PCR的方法检测3组尿液miR-128a和miR-28-3p的表达。观察3组尿液中miR-128a和miR-28-3p表达水平,比较术前术后前列腺癌表达水平的变化,与临床病理因素和预后的关系,及其在诊断和判断预后的诊断效能。结果前列腺癌组尿液miR-128a表达水平明显高于前列腺良性增生组和健康对照组(P<0.01),且前列腺良性增生组表达水平明显高于健康对照组(P<0.01),术后前列腺癌组尿miR-128a表达较术前明显降低(P<0.01);而前列腺癌组尿液miR-28-3p表达明显低于前列腺良性增生组合健康对照组(P<0.01),而良性前列腺增生组明显低于健康对照组(P<0.01),术后前列腺癌组的miR-28-3p表达水平较术前出现明显升高(P<0.01)。尿miR-128a和miR-28-3p表达水平与Gleason评分、肿瘤直径、分化类型和肿瘤分期具有明显的相关性(P<0.05或<0.01),而年龄和PSA水平无明显相关性(P>0.05)。随访2年,死亡组的尿miR-128a表达水平明显高于存活组(P<0.01),而尿miR-28-3p表达水平死亡组低于存活组(P<0.01)。尿miR-128a和miR-28-3p表达水平在前列腺诊断和预测预后具有较高的灵敏度和特异性,联合检测的诊断效能明显优于单个指标miR-128a和miR-28-3p(P<0.01),而miR-128a与miR-28-3p比较差异无统计学意义(P>0.05)。结论MiR-128a和miR-28-3p参与了前列腺癌的发生发展,在诊断前列腺癌和判断预后具有重要临床价值。

Objective To investigate the application value of combined detection of urine miR-128a and miR-28-3p in diagnosis and prognosis assessment of prostate cancer.Methods A total of 117 urine specimens of patients with prostate cancer who were treated in our hospital from January 2013 to December 2016 were enrolled as prostate cancer group,at the same time,the other 75 urine specimens of patients with benign prostatic hyperplasia were enrolled as prostatic hyperplasia group,moreover,the 30 specimens from healthy subjects were enrolled as control group.The expression levels of urine miR-128a and miR-28-3p were detected by qRT-PCR.The expression levels of urine miR-128a and miR-28-3p were observed and compared among the three groups.In addition the changes of the expression levels of these indexes in patients with prostate cancer were observed and compared before surgery and after surgery,and their correlation with clinical pathological factors and prognosis of patients,and the efficacy in diagnosis and prognosis assessment of prostate cancer were analyzed.Results The expression levels of miR-128a in prostate cancer group were significantly higher than those in prostatic hyperplasia group and control group(P<0.01),which in prostatic hyperplasia group were significantly higher than those in control group(P<0.01).The expression levels of miR-128a in prostate cancer group after surgery were significantly lower than those before surgery(P<0.01),moreover,the expression levels of miR-28-3p in prostate cancer group were significantly lower than those in prostatic hyperplasia group(P<0.01),which in benign prostatic hyperplasia group were significantly lower than those in control group(P<0.01).After surgery the expression levels of miR-28-3p in prostate cancer group were significantly higher than those before surgery(P<0.01).The expression levels of urinary miR-128a and miR-28-3p were significantly correlated with Gleason score,tumor diameter,differentiation type and tumor stage(P<0.05 or<0.01),however,which were not significantly correlated with patient’s age and PSA levels(P>0.05).After 2-year follow-up,the expression levels of urinary miR-128a in death case group were significantly higher than those in survival case group(P<0.01),however,the expression levels of urinary miR-28-3p in death case group were significantly lower than those in survival case group(P<0.01).The detection of expression levels of urinary miR-128a and miR-28-3p had higher sensitivity and specificity in diagnosis and prognosis assessment of prostate cancer,and the diagnostic efficacy of combined detection was superior to that by simple index detection(P>0.05).Conclusion The miR-128a and miR-28-3p are involved in the pathogenesis and development of prostate cancer,which have important clinical value in diagnosis and prognosis assessment of prostate cancer.