前列腺健康指数联合可溶性上皮钙黏蛋白对前列腺癌的诊断价值

Diagnostic value of prostate health index plus soluble E-cadherin for prostate cancer

目的分析前列腺健康指数(PHI)联合可溶性上皮钙黏蛋白(sE-cadherin)对前列腺癌(PCa)的诊断价值,为提高疾病检出率的方法研究提供参考。方法选取2018年1月—2023年1月广州医科大学附属第五医院收治的200例良性前列腺增生(BPH)患者作为BPH组,200例PCa患者作为PCa组。将PCa组患者按照不同分期分为Ⅰ~Ⅱ期亚组(n=92)、Ⅲ~Ⅳ期亚组(n=108);按照是否合并骨转移分为无骨转移亚组(n=146)及骨转移亚组(n=54);按照Gleason评分分为≤8分亚组(n=111)及>8分亚组(n=89)。各组均采用酶联免疫吸附法试剂盒检测血清sE-cadherin,采用化学发光分析仪检测总前列腺特异抗原(tPSA)、游离前列腺特异性抗原(fPSA)、前列腺特异性抗原同源异构体2(p2PSA),并根据公式计算PHI。采用受试者工作特征(ROC)曲线分析sE-cadherin联合PHI对PCa的诊断价值。结果与BPH组比较,PCa组患者sE-cadherin、tPSA、p2PSA水平及PHI均升高(P<0.05);与Ⅰ~Ⅱ期PCa患者比较,Ⅲ~Ⅳ期患者的sE-cadherin、tPSA、p2PSA水平及PHI均升高(P<0.05);与无骨转移PCa患者比较,骨转移患者的sE-cadherin、tPSA、p2PSA水平及PHI均升高(P<0.05);与Gleason评分≤8分PCa患者比较,>8分患者的sE-cadherin、tPSA、p2PSA水平及PHI均升高(P<0.05)。sE-cadherin、PHI单独及联合诊断PCa的ROC曲线下面积(AUC)分别为0.719、0.761及0.792,联合诊断AUC最高。结论PCa患者的sE-cadherin水平及PHI均高于BPH,且随着患者分期升高、合并骨转移及Gleason评分的增加而升高,二者联合检测可能有助于提高PCa的诊断效能。

Objective To analyze the diagnostic value of prostate health index(PHI)plus soluble E-cadherin(sE-cadherin)for prostate cancer(PCa),so as to provide reference for the methods to enhance the detection rate of this disease.Methods A total of 200 patients with benign prostatic hyperplasia(BPH)admitted to our hospital during Jan.2018 and Jan.2023 were selected as the BPH group,and 200 PCa patients were enrolled as the PCa group.According to the different stages of the disease,the PCa patients were divided into stageⅠ-Ⅱ(n=92)and stageⅢ-Ⅳ(n=108)groups;according to the presence or absence of bone metastasis,they were divided into non-bone metastasis(n=146)and bone metastasis(n=54)groups;according to the Gleason score,they were divided into≤8(n=111)and>8(n=89)groups.Serum sE-cadherin was detected with ELISA kit.Total prostate specific antigen(tPSA),free prostate specific antigen(fPSA)and isoform[-2]prostate-specific antigen(p2PSA)were detected with chemiluminescence analyzer and PHI was calculated according to the formula.The diagnostic value of sE-cadherin combined with PHI for PCa was analyzed using receiver operating characteristic(ROC)curve analysis.Results Compared with the BPH group,the PCa group had elevated levels of sE-cadherin,tPSA,p2PSA and PHI(P<0.05).Compared with patients with stageⅠ-ⅡPCa,stageⅢ-Ⅳpatients had increased levels of sE-cadherin,tPSA,p2PSA and PHI(P<0.05).PCa patients with bone metastasis had higher levels of sE-cadherin,tPSA,p2PSA and PHI than those without bone metastasis(P<0.05).Patients with Gleason score>8 had higher levels of sE-cadherin,tPSA,p2PSA and PHI than those with Gleason score≤8(P<0.05).The area under the ROC curve(AUC)of sE-cadherin,PHI alone,and combined diagnosis were 0.719,0.761,and 0.792,respectively,the combined diagnosis had the highest AUC.Conclusion The levels of sE-cadherin and PHI are higher in PCa patients than in BPH patients,which increase with the increase of stage,bone metastasis and Gleason score.PHI plus sE-cadherin testing may help for the diagnose of PCa.