巢式RT-PCR检测前列腺癌患者外周血中PSA mRNA和PSM mRNA的比较

Comparison of nested reverse transcription polymerase chain reaction detection of circulating prostate-specific membrane antigen mRNA and prostate-specific antigen mRNA in patients with prostatic carcinoma

目的 盲法比较研究巢式反转录聚合酶链反应 (RT PCR)检测前列腺癌 (PC)患者外周血中前列腺特异性膜抗原(PSM)mRNA和前列腺特异性抗原 (PSA)mRNA在PC诊断中的真实性和可靠性 .方法 根据PSM和PSA的cDNA序列设计合成引物 .应用巢式RT PCR方法分别检测 36例PC患者和 2 3例前列腺增生 (BPH)患者外周血中PSMmRNA和PSAmRNA .结果 PSAmRNA和PSMmRNA阳性表达的灵敏度 (Sen)分别为 :2 9.7% ,6 7.6 % (P <0 .0 1) .特异度 (Spe)分别为 :86 .4 % ,10 0 .0 % (P <0 .0 5 ) .准确度 (Ac)分别为 :5 0 .8% ,79.8% (P <0 .0 5 ) .卡柏值 (κ)分别为 :0 .13(差 )、0 .6 (一般 ) .结论 应用巢式RT PCR方法 ,患者外周血中PSMmR NA在PC的诊断、微转移、术后随访、人群筛选中的真实性和可靠性明显优于PSAmRNA .

AIM To evaluate the accuracy and reliability of nested reverse transcription polymerase chain reaction (RT PCR) detection of circulating prostate specific antigen (PSM)mRNA and prostate specific antigen (PSA) mRNA in patients with prostatic carcinoma (PC) by blind study. METHODS A total of 59 patients were included in the study, 36 with PC and 23 with benign prostate hyperplasia (BPH). Nested RT PCR assay using primers derived from the cDNA sequences of PSA and PSM was performed. RESULTS The sensitivity of PSA mRNA and PSM mRNA was 29.7% and 67.6% ( P <0.01), the specificity 86.4% and 100% ( P <0.05) and the accuracy is 50.8% and 79.8% ( P <0.05), individually. The κ values was 0.13 and 0.60, separately. CONCLUSION Nested RT PCR detection of circulating PSM mRNA proves to be a more accurate and reliable method in diagnosing and evaluating PC than detection of PSA mRNA.