嗜铬粒蛋白A在前列腺癌诊断中的意义

Significance of plasma chromogranin A in diagnosis of prostate cancer

目的 探讨血清嗜铬粒蛋白A(CgA)在前列腺癌 (PCa)诊断中的作用。 方法 采用ELISA法测定 30例健康志愿者 ,35例前列腺癌患者及 10例良性前列腺增生 (BPH)患者的血清CgA ,分析比较各组CgA的水平。 结果 PCa患者血清CgA(16 2± 12 .5 )ng/ml,与正常对照组 (6 0 .2± 19.8)ng/ml及BPH组 (81.3± 4 3.0 )ng/ml比较差异有显著性意义 (P <0 .0 5 )。血清CgA水平随癌分期的升高而升高 ,D2 患者血清CgA水平明显高于正常对照组及其他分期PCa组 (P分别 <0 .0 1和 <0 .0 5 )。CgA和前列腺特异抗原 (PSA)联合检测可提高对前列腺癌的诊断价值 ,平行试验敏感度83% ,系列试验特异度 93%。 结论 血清CgA水平可应用于前列腺癌的诊断、监测和疗效观察 ,尤其对PSA阴性或伴有远隔转移的病例具有重要意义。

Objective To evaluate the application of chromogranin A (CgA) as a marker in the diagnosis of prostate cancer. Methods Serum chromogranin A were detected by means of ELISA technique in 35 cases of prostate carcinoma,10 cases of benign prostate hyperplasia and 30 cases of healthy subjects. Results Serum CgA [(162±12.5)ng/ml] of patients with prostatic carcinoma was significantly higher than those of healthy subjects and of BPH( P <0.05),and it increased with escalation of clinical stage.Serum CgA of D 2 stage was significantly higher than those in healthy subjects and in B,C and D 1 stage of prostate cancer ( P <0.01 and <0.05).The combined assay of serum PSA and CgA could raise the detection rate of prostate cancer.The sensitivity of parallel trials reached 83% and the specificity of serial trials reached 93%. Conclusions The determination of serum levels of CgA is useful in the diagnosis,treatment,evaluation and prognosis of prostatic cancer,especially for patients who are PSA negative or have distant metastasis.