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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

19卷

期数:

2013年06期

页码:

487-489

栏目:

临床医学

出版日期:

2013-11-20

文章信息/Info

Title:

Clinical significance of urinary PCA3 score to diagnose prostate cancer

作者:

杨帮东; 姜行康; 齐 灿; 李海波; 刘冉录; 杨 阔; 乔宝民; 张志宏; 徐 勇

天津医科大学第二医院泌尿外科，天津市泌尿外科研究所，天津300211

Author(s):

YANG Bang-dong;  JIANG Xing-kang;  QI Can;  LI Hai-bo;  LIU Ran-lu;  YANG Kuo;  QIAO Bao-min;  ZHANG Zhi-hong;  XU Yong

Department of Urology, The Second Hospital,Tianjin Medical University, Tianjin Institute of Urology,Tianjin 300211,China

关键词:

前列腺癌; 前列腺癌基因3; 尿前列腺癌基因3评分; 穿刺活检

Keywords:

-

分类号:

R737.25

DOI:

-

文献标志码:

A

摘要:

目的：探讨不同尿液中前列腺癌基因３ （ＰＣＡ３）评分的截断值对可疑前列腺癌患者诊断的应用价值。 方法：纳入１２３例因血清总前列腺特异性抗原（ｔ－ＰＳＡ）升高和（或）直肠指诊（ＤＲＥ）异常住院的患者，采集前列腺按摩后的初始尿液标本，使用实时定量ＰＣＲ检测尿沉渣中ＰＳＡ及ＰＣＡ３ ｍＲＮＡ的表达，测定穿刺前尿样ＰＣＡ３的评分。结合穿刺的病理结果分析不同尿ＰＣＡ３评分的截断值对诊断前列腺癌的敏感性和特异性（阳性预测和阴性预测）。 结果：经穿刺病理结果证实前列腺癌３２例，前列腺良性增生９１例。当取ＰＣＡ３评分截断值为３５时，可避免５２．７％（４８例）的患者进行不必要的穿刺，８．８％（８例）的患者被漏诊（被漏诊的患者均是低危前列腺癌）；当取ＰＣＡ３评分截断值为 ５０时，可避免７２．５％（６６例）的患者进行不必要的穿刺，但１３．２％（１２例）的患者被漏诊，且２例（１６．７％）是中高危前列腺癌。 结论：检测可疑前列腺癌患者尿液中ＰＣＡ３ 评分可减少不必要的穿刺，且取截断值为３５时可获得较高的诊断价值。

Abstract:

Objective: To investigate ｔｈｅ ｖａｌｕｅ ｏｆ ｔｈｅ ｄｉｆｆｅｒｅｎｔ ｕｒｉｎａｒｙ ＰＣＡ ３（ｐｒｏｓｔａｔｅ ｃａｎｃｅｒ ｇｅｎｅ ３） ｓｃｏｒｅ ｉｎ ｄｉａｇｎｏｓｉｓ ｏｆ ｓｕｓｐｅｃｔｅｄ ｐｒｏｓｔａｔｅ ｃａｎｃｅｒ ． Ｍｅｔｈｏｄｓ：Ｓａｍｐｌｅｓ ｗｅｒｅ ｏｂｔａｉｎｅｄ ｆｒｏｍ １２３ ｍｅｎ ｗｉｔｈ ｉｎｃｒｅａｓｅｄ ｓｅｒｕｍ ｔｏｔａｌ ｐｒｏｓｔａｔｅ ｓｐｅｃｉfiｃ ａｎｔｉｇｅｎ ａｎｄ／ｏｒ ａｂｎｏｒｍａｌ ｄｉｇｉｔａｌ ｒｅｃｔａｌ ｅｘａｍｉｎａｔｉｏｎ ｂｅｆｏｒｅ ｔｒａｎｓｒｅｃｔａｌ ｐｒｏｓｔａｔｅ ｎｅｅｄｌｅ ｂｉｏｐｓｙ． Ｔｈｅ ｕｒｉｎａｒｙ ＰＳＡ ａｎｄ ＰＣＡ３ ｍＲＮＡ ｂｅｆｏｒｅ ｂｉｏｐｓｙ ｗｅｒｅ ｔｅｓｔｅｄ ｔｏ ｃａｌｃｕｌａｔｅ ｔｈｅ ａｓｓｏｃｉａｔｅｄ ＰＣＡ３ ｓｃｏｒｅ． Ｂａｓｅｄ ｏｎ ｐａｔｈｏｌｏｇｉｃ ｒｅｓｕｌｔｓ ｏｆ ｄｉｆｆｅｒｅｎｔ ｇｒｏｕｐｓ， ｔｈｅ ｓｅｎｓｉｔｉｖｉｔｙ ａｎｄ ｓｐｅｃｉfiｃｉｔｙ ｏｆ ｐｒｏｓｔａｔｅ ｃａｎｃｅｒ ｗｅｒｅ ｍａｎｉｆｅｓｔｅｄ ｂｙ ｕｒｉｎａｒｙ ＰＣＡ ３ ｓｃｏｒｅ． Ｒｅｓｕｌｔｓ：Ｔｈｉｒｔｙ-ｔｗｏ ｐａｔｉｅｎｔｓ ｗｅｒｅ ｄｉａｇｎｏｓｅｄ ｗｉｔｈ ｐｒｏｓｔａｔｅ ｃａｎｃｅｒ， ａｎｄ ９１ ｗｅｒｅ ｂｅｎｉｇｎ ｐｒｏｓｔａｔｉｃ ｈｙｐｅｒｐｌａｓｉａ． ＰＣＡ３ ｃｕｔｏｆｆ ｏｆ ３５ ｃｏｕｌｄ ｈａｖｅ ａｖｏｉｄｅｄ ５２．７％ （４８ ｐａｔｉｅｎｔｓ） ｎｅｇａｔｉｖｅ ｂｉｏｐｓｉｅｓ， ｅｖｅｎｔｕａｌｌｙ ｍｉｓｓｉｎｇ ８．８％ （８ ｐａｔｉｅｎｔｓ） ｗｉｔｈ ｃａｎｃｅｒｓ （ｌｏｗ ｒｉｓｋ）； ＰＣＡ３ ｃｕｔｏｆｆ ｏｆ ５０ ｗｏｕｌｄ ｈａｖｅ ｐｒｅｖｅｎｔｅｄ ７２．５％ （６６ ｐａｔｉｅｎｔｓ） ｏｆ ｎｅｇａｔｉｖｅ ｂｉｏｐｓｉｅｓ， ｍｉｓｓｉｎｇ １３．２％ （１２ ｐａｔｉｅｎｔｓ）， ａｎｄ １６．７％ （２ ｐａｔｉｅｎｔｓ） ｐｏｔｅｎｔｉａｌｌｙ ａｇｇｒｅｓｓｉｖｅ． Ｃｏｎｃｌｕｓｉｏｎ：Ｕｒｉｎａｒｙ ＰＣＡ３ ｓｃｏｒｅ ｈａｓ ｔｈｅ ｐｏｔｅｎｔｉａｌ ｔｏ ｒｅｄｕｃｅ ｔｈｅ ｎｕｍｂｅｒ ｏｆ ｕｎｎｅｃｅｓｓａｒｙ

参考文献/References:

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备注/Memo

备注/Memo:

文章编号 １００６－８１４７（２０13）０6-0487-03 作者简介 杨帮东（1986-），男，硕士在读，研究方向：泌尿系统肿瘤；通信作者：徐勇，E-mail：xuyong8816@sina.com。

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更新日期/Last Update: 2013-12-20