特异性血清标志物在良恶性前列腺病变组织中的表达及其临床意义

Expression of specific serum markers in the tissues of patients with benign and malignant prostatic lesions and their clinical significance

目的探讨PSA、p63、34βE12、P504S、PSAP等特异性血清标志物在良恶性前列腺病变患者组织中的表达水平及其临床意义。方法选取2020年1月至2022年1月90例经前列腺电切术及穿刺活检的组织标本,良恶性前列腺病变分为良性前列腺增生(BPH)组(n=50,例)、前列腺癌(PCa)组(n=40,例),其中PCa组依据Gleason评分进一步划分为低中、高危组(n分别为14、26,例)。检测所有组织中PSA、p63、34βE12、P504S、PSAP表达水平,比较两组血清PSA水平及PSA、p63、34βE12、P504S、PSAP的阳性表达检出情况;分析PSA、p63、34βE12、P504S、PSAP表达与PCa临床病理特征的关系;分析前列腺癌Gleason分级与PSA、p63、34βE12、P504S、PSAP表达相关性分析。结果PCa组平均血清PSA水平为(76.22±11.22)ng/mL,显著高于BHP组的(16.36±5.82)ng/mL,差异存在统计学意义(P<0.05)。PSA、P504S、PSAP在PCa组中呈现高表达,阳性检出率显著升高;而p63、34βE12在BHP组中呈现高表达,阳性检出率显著降高(P<0.05)。而PSA、p63、34βE12、P504S、PSAP阳性表达与PCa患者年龄无关(P>0.05);与前列腺体积、淋巴结转移、TNM分期及Gleason分级相关(P<0.05)。PCa患者Gleason分级与PSA、P504S、PSAP表达呈正相关(rs=0.733、0.682、0.746,P<0.01),而与p63、34βE12呈负相关(rs=-0.826、-0.719,P<0.01)。结论特异性血清标志物PSA、p63、34βE12、P504S、PSAP的联合检测对早期区别良恶性前列腺疾病具有重要意义,其临床检出率对PCa的临床分期、癌症级别、治疗方案及预后均有一定价值。

Objective To investigate the expression levels of specific serum markers such as PSA,p63,34βE12,P504S and PSAP in the tissues of patients with benign and malignant prostatic lesions and their clinical significance.Methods 90 tissue specimens preserved by prostate electrosurgery and puncture biopsy were selected from January 2020 to January 2022 in our department.The benign and malignant prostate lesions were divided into benign prostatic hyperplasia group(n=50,cases)and prostate cancer group(n=40,cases),in which the prostate cancer group was further divided into low-intermediate and high-risk groups according to Gleason score(n=14、26,cases respectively).The expression levels of PSA,p63,34βE12,P504S and PSAP were detected in all tissues,and the serum PSA levels and the positive expression of PSA,p63,34βE12,P504S and PSAP were compared between the two groups.The relationship between PSA,p63,34βE12,P504S and PSAP expression and the clinicopathological features of PCa was analysed.The relationship between Gleason grading and PSA,p63,34βE12,P504S,PSAP expression was analysed.Results The mean serum PSA level in the PCa group was(76.22±11.22)ng/mL significantly higher than that in the BHP group(16.36±5.82)ng/mL,and the difference was statistically significant(P<0.05).PSA,P504S and PSAP showed high expression in the PCa group,and the positive detection rate was significantly higher(P<0.05).The detection rate was significantly higher in the PCa group,while p63 and 34βE12 showed high expression in the BHP group,and the positive detection rate was significantly lower(P<0.05).The positive expression of PSA,p63,34βE12,P504S and PSAP was not associated with the age of PCa patients(P>0.05).It was associated with prostate volume,lymph node metastasis,TNM stage and Gleason classification(P<0.05).Moreover,Gleason grade in PCa patients was positively correlated with PSA,P504S and PSAP expression(r s=0.733,0.682,0.746,P<0.01),while it was negatively correlated with p63 and 34βE12(r s=-0.826,-0.719,P<0.01).Conclusion The combination of specific serum markers PSA,p63,34βE12,P504S and PSAP is important for the early differentiation of benign and malignant prostate diseases,and their clinical detection rate is valuable for clinical staging,cancer grade,treatment options and prognosis of PCa.