前列腺小体外泄蛋白在前列腺癌患者中的表达及其临床意义

Expression and clinical significance of prostatic exosomal protein in patients with prostate cancer

目的 分析前列腺癌患者尿液中前列腺小体外泄蛋白(PSEP)表达情况,探讨PSEP与患者预后的相关性。方法 选取2017年10月至2019年10月于襄阳市中心医院确诊的114例前列腺癌患者作为前列腺癌组,根据随访3年期间患者癌因死亡情况将其分为生存组(n=84)和死亡组(n=30);选取同期同院诊治的108例前列腺炎患者作为前列腺炎组。采用酶联免疫吸附试验(ELISA)法检测前列腺癌组和前列腺炎组患者尿液PSEP表达水平;绘制Kaplan-Meier曲线分析尿液中PSEP表达水平与前列腺癌患者3年生存率的关系;前列腺癌患者3年预后的影响因素采用多因素Cox回归分析检验。结果 前列腺癌组尿液中PSEP表达水平显著低于前列腺炎组(P<0.05)。TNM分期Ⅲ+Ⅳ期、有淋巴结转移的前列腺癌患者尿液中PSEP表达水平显著低于TNM分期Ⅰ+Ⅱ期、无淋巴结转移患者(P<0.05)。PSEP高表达前列腺癌患者3年生存率显著高于PSEP低表达前列腺癌患者(P<0.05)。死亡组TNM分期Ⅲ+Ⅳ期、有淋巴结转移患者比例显著高于生存组(P<0.05)。PSEP是前列腺癌患者3年内死亡的保护因素(P<0.05)。结论 前列腺癌患者尿液中PSEP表达水平显著低于前列腺炎患者,其水平与TNM分期、淋巴结转移密切相关,且能预测前列腺癌患者3年生存情况。

Objective To detect the expression of prostatic exosomal protein(PSEP)in the urine of patients with prostate cancer,and to explore the correlation between the expression of PSEP and prognosis of patients.Methods A total of 114 patients with prostate cancer diagnosed in Xiangyang Central Hospital from October 2017 to October 2019 were included in the prostate cancer group,the patients were divided into survival group(84 cases)and death group(30 cases)according to their cancer deaths during the 3-year follow-up period.A total of 108 patients with prostatitis treated in the same hospital at the same period were collected as the prostatitis group.The expression of PSEP in urine of patients with prostate cancer and prostatitis was detected by enzyme-linked immunosorbent assay(ELISA);Kaplan-Meier curve was drawn to analyze the relationship between the expression level of PSEP in urine and the 3-year survival rate of prostate cancer patients;multivariate Cox regression analysis was used to examine the influencing factors of 3-year prognosis of prostate cancer patients.Results The expression level of PSEP in urine in prostate cancer group was obviously lower than that in prostatitis group(P<0.05).The expression level of PSEP in urine of patients with Tumor Node Metastasis(TNM)stageⅢ+Ⅳand lymph node metastasis was obviously lower than that of patients with TNM stageⅠ+Ⅱand no lymph node metastasis(P<0.05).The 3-year survival rate of prostate cancer patients with high expression of PSEP was obviously higher than that of prostate cancer patients with low expression of PSEP(P<0.05).The proportions of patients with TNM stageⅢ+Ⅳand lymph node metastasis in death group were obviously higher than those in survival group(P<0.05).PSEP was a protective factor of death of prostate cancer patients within 3 years(P<0.05).Conclusions The expression level of PSEP in urine of patients with prostate cancer is obviously lower than that of patients with prostatitis.The expression level is closely related to the clinical and pathological characteristics of TNM stage and lymph node metastasis,and can predict the 3-year survival of prostate cancer patients.