PCA3檢測(cè)在PSA灰區(qū)對(duì)前列腺癌診斷及病理分級(jí)的價(jià)值
本文選題:前列腺癌抗原3 切入點(diǎn):前列腺癌 出處:《山西醫(yī)科大學(xué)》2017年碩士論文
【摘要】:目的:研究外周血前列腺癌抗原3(PCA3)在前列腺特異性抗原(PSA)灰區(qū)(4-10ng/ml)時(shí)對(duì)前列腺癌的診斷價(jià)值;通過測(cè)定PCA3在前列腺癌不同病理分級(jí)患者中的表達(dá)量研究其與前列腺癌病理分級(jí)(分化程度)的關(guān)系。方法:隨機(jī)選取2016年4月至2016年12月間山西醫(yī)科大學(xué)第一醫(yī)院泌尿外科住院的前列腺癌患者30例作為試驗(yàn)組,另選取良性前列腺增生患者34例作為對(duì)照組,并且其血PSA均為4-10ng/ml。采用實(shí)時(shí)熒光PCR技術(shù)檢測(cè)兩組外周血單個(gè)核細(xì)胞中PCA3 m RNA相對(duì)表達(dá)量,并統(tǒng)計(jì)前列腺癌組PCA3 m RNA相對(duì)表達(dá)量與高分化(Gleason評(píng)分2-4分)、中分化(Gleason評(píng)分5-6分)、低分化(Gleason評(píng)分7-10分)前列腺癌的關(guān)系。結(jié)果:在64例受試者中,30例經(jīng)病理診斷為前列腺癌,其PCA3的相對(duì)表達(dá)量為2.50±1.79;34例為良性前列腺增生,其PCA3的相對(duì)表達(dá)量為1.01±0.54,P0.05,差異有統(tǒng)計(jì)學(xué)意義。表明PCA3 m RNA高表達(dá)于前列腺癌患者血液,在良性前列腺增生患者中低表達(dá)。30例前列腺癌患者中,8例Gleason評(píng)分為7-10分,其PCA3的相對(duì)表達(dá)量為4.40±2.27;17例Gleason評(píng)分為5-6分,其PCA3的相對(duì)表達(dá)量為2.13±0.76;5例Gleason評(píng)分為2-4分,其PCA3的相對(duì)表達(dá)量為0.72±0.28,三組之間兩兩相比差異均有統(tǒng)計(jì)學(xué)意義,表明低分化組前列腺癌患者PCA3 m RNA相對(duì)表達(dá)量高于中分化組及高分化組前列腺癌的患者,中分化組前列腺癌患者PCA3 m RNA相對(duì)表達(dá)量高于高分化組前列腺癌的患者。結(jié)論:在PSA處于灰區(qū)的患者中,PCA3 m RNA相對(duì)表達(dá)量越高,患前列腺癌可能性越大,可為前列腺癌篩查提供參考,穿刺活檢陽性率高;在PSA處于灰區(qū)的前列腺癌患者中,PCA3 m RNA相對(duì)表達(dá)量越高,前列腺癌病理分級(jí)越高,前列腺癌細(xì)胞惡性程度越大,分化程度越低,提示預(yù)后較差。
[Abstract]:Objective: to study the diagnostic value of peripheral blood prostate cancer antigen (PCA3) in the prostate specific antigen (PSA) gray region (4-10 ng / ml). The relationship between the expression of PCA3 and the pathological grade (differentiation) of prostate cancer was studied by measuring the expression of PCA3 in patients with different pathological grades of prostate cancer. Methods: the first one of Shanxi Medical University from April 2016 to December 2016 was randomly selected. Thirty patients with prostate cancer in urology department were treated as trial group. 34 patients with benign prostatic hyperplasia (BPH) were selected as control group and their blood PSA was 4-10 ng / ml. The relative expression of PCA3 m RNA in peripheral blood mononuclear cells was detected by real-time fluorescent PCR technique. The relationship between the relative expression of PCA3 m RNA and Gleason score 2-4, Gleason score 5-6, Gleason score 7-10) was analyzed. Results: 30 of 64 subjects were pathologically diagnosed as prostate cancer. The relative expression of PCA3 was 2.50 鹵1.79m in 34 patients with benign prostatic hyperplasia, and the relative expression of PCA3 was 1.01 鹵0.54g P0.05.The results showed that PCA3 m RNA was highly expressed in the blood of patients with prostate cancer. The Gleason score was 7-10 in 8 patients with benign prostatic hyperplasia, the relative expression of PCA3 was 5-6 in 17 patients with Gleason, and the relative expression of PCA3 was 2.13 鹵0.760.The Gleason score was 2-4 in 5 patients with benign prostatic hyperplasia. The relative expression of PCA3 was 0.72 鹵0.28, the difference between the three groups was statistically significant, which indicated that the relative expression of PCA3 m RNA in the low differentiated prostate cancer patients was higher than that in the moderately differentiated prostate cancer patients and the well-differentiated prostate cancer patients. The relative expression of PCA3 m RNA in moderately differentiated prostate cancer patients was higher than that in well differentiated prostate cancer patients. Conclusion: the higher the relative expression of PCA3 m RNA in patients with PSA in gray zone, the more likely it is to develop prostate cancer. The higher the relative expression of PCA3 m RNA, the higher the pathological grade of prostate cancer, and the greater the malignant degree of prostate cancer cells, the higher the positive rate of puncture biopsy in prostate cancer screening, the higher the relative expression of PCA3 m RNA in prostate cancer patients in the gray area of PSA, and the higher the pathological grade of prostate cancer is. The lower the degree of differentiation, the worse the prognosis.
【學(xué)位授予單位】:山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類號(hào)】:R737.25
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