摘要
目的·探讨前列腺癌患者血液中前列腺特异抗原(prostate specific antigen,PSA)、肿瘤异常蛋白(tumor abnormal protein,TAP)及结肠癌转移相关基因1(colon cancer metastasis related gene 1,MACC1)的表达及临床诊断价值。方法·以2019年1月至2020年12月于上海市徐汇区大华医院就诊的107例前列腺癌患者为病例组,另选择同期该院60名健康体检者为对照组。回顾性分析2组患者血液中PSA、TAP及MACC1的水平,及其与Gleason评分、T分期的相关性;采用受试者操作特征(receiver operating characteristic,ROC)曲线评价各项指标诊断前列腺癌的灵敏度和特异度。结果·病例组患者血液PSA、TAP及MACC1水平均显著高于对照组(P<0.05);随着Gleason分级的升高,病例组患者血液PSA、TAP及MACC1水平逐渐升高;随着T分期的进展,病例组患者血液PSA、TAP及MACC1水平逐渐升高;有淋巴结转移的患者血液PSA和MACC1水平高于无淋巴结转移患者,TAP水平低于无淋巴结转移患者,差异均有统计学意义(P<0.05)。血液PSA诊断前列腺癌的ROC曲线下面积(area under the curve,AUC)为0.764,灵敏度为86.12%,特异度为88.63%,截断值为6.01μg/L;血液TAP诊断前列腺癌的AUC为0.796,灵敏度为88.18%,特异度为89.58%,截断值为135.62μm^(2);血液MACC1诊断前列腺癌的AUC为0.873,灵敏度为78.46%,特异度为80.10%,截断值为37.80 pg/mL;3项指标联合检测的AUC为0.941,灵敏度为93.15%,特异度为94.08%,均高于各单项指标(P<0.05)。Spearman相关分析结果显示,血液PSA、TAP及MACC1水平均与Gleason评分呈正相关(r值分别为0.648、0.513和0.501,均P=0.000),与T分期呈正相关(r值分别为0.616、0.537和0.542,均P=0.000)。结论·前列腺癌患者血液PSA、TAP及MACC1水平均与Gleason评分、T分期之间关系密切,对前列腺癌有一定的诊断价值;3项联合检测,诊断价值更高。
Objective·To investigate the expression and diagnostic value of prostate specific antigen(PSA),tumor abnormal protein(TAP)and colon cancer metastasis related gene 1(MACC1)in the blood of patients with prostate cancer.Methods·One hundred and seven patients with prostate cancer(case group)admitted to Dahua Hospital,Xuhui District,Shanghai,from January2019 to December 2020 were retrospectively analyzed,and 60 healthy people(control group)who underwent physical examination in the hospital in the same period were selected.The levels of blood PSA,TAP and MACC1 in the two groups,as well as their correlation with Gleason score and T stage,were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the value of various indexes in the diagnosis of prostate cancer.Results·The levels of blood PSA,TAP and MACC1 in the case group were significantly higher than those in the control group(P<0.05).With the increase of Gleason grade,the levels of blood PSA,TAP and MACC1 increased gradually.With the progress of T stage,the levels of blood PSA,TAP and MACC1 increased gradually.The levels of PSA and MACC1 in the patients with lymph node metastasis were significantly higher than those without lymph node metastasis,but the levels of TAP in the patients with lymph node metastasis were significantly lower than those without lymph node metastasis(P<0.05).The analysis results of ROC curve showed that the AUC of PSA in the diagnosis of prostate cancer was 0.764,the sensitivity was 86.12%,the specificity was 88.63%,and the cut-off value was 6.01μg/L.The AUC of TAP in the diagnosis of prostate cancer was 0.796,the sensitivity was 88.18%,the specificity was 89.58%,and the cut-off value was 135.62μm^(2).The AUC of MACC1 in the diagnosis of prostate cancer was 0.873,the sensitivity was 78.46%,the specificity was 80.10%,and the cut-off value was 37.80 pg/mL.The AUC(0.941),sensitivity(93.15%)and specificity(94.08%)of combined detection were higher than those of any single detection(P<0.05).Spearman correlation analysis showed that the blood PSA,TAP and MACC1 levels were positively correlated with Gleason score(r=0.648,0.513,0.501;P=0.000),and with T stage(r=0.616,0.537,0.542;P=0.000).Conclusion·Blood PSA,TAP and MACC1 are closely related to Gleason score and T stage of prostate cancer,which has some value in the diagnosis of prostate cancer,and the combined detection of three items has higher diagnostic value.
作者
王慧
赵莹
温丽蓉
曹军
羊继平
原永明
WANG Hui;ZHAO Ying;WEN Lirong;CAO Jun;YANG Jiping;YUAN Yongming(Department of Laboratory,Dahua Hospital,Xuhui District,Shanghai 200237,China;Department of Labratory,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Interventional Oncology,Dahua Hospital,Xuhui District,Shanghai 200237,China;Department of Urology,Dahua Hospital,Xuhui District,Shanghai 200237,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2022年第4期496-501,共6页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市徐汇区智慧医疗研究项目(XHZH202102)。
