本文選題：前列腺癌 + 前列腺增生��； 參考：《河北大學(xué)》2017年碩士論文

【摘要】：目的:應(yīng)用熒光探針SLeX(Sialyl-Lewis X,唾液酸化的路易斯寡糖-X抗原)檢測血清樣本,建立前列腺癌診斷新方法,提高前列癌的早期診斷率。探討熒光探針SLeX在前列腺癌診斷中的應(yīng)用的價值及在臨床TNM分期、病理分級及Gleason評分中的意義。方法:選取2015年1月～2016年12月河北大學(xué)附屬醫(yī)院泌尿外科住院患者76例,其中前列腺增生患者38例(BPH組)、前列腺癌患者38例(PCa組),兩組均由前列腺穿刺或/和術(shù)后病理診斷。前列腺癌組按2002年美國癌癥聯(lián)合會(AJCC)TNM分期分為局限性組(T1、T2期)16例和非局限組(T3、T4期)22例;按Gleason評分(2～4分屬高分化癌;5～7分為中分化癌;8～10分為低分化癌)分為高分化癌、中分化癌、低分化癌分別為12例、10例、16例。以熒光探針SLeX作為檢測抗體,應(yīng)用ELISA法(酶聯(lián)免疫吸附)檢測血清中PSA-SLeX(前列腺特異性唾液酸化的路易斯寡糖-X抗原)的表達(dá)含量,與我院檢驗科現(xiàn)行的雙位點酶免法檢測血清方法(雙抗體夾心法)檢測血清TPSA表達(dá)含量,比較分析兩種檢測方法在前列腺癌診斷中的應(yīng)用的價值及在臨床TNM分期、病理分級及Gleason評分中的意義的可行性及意義。結(jié)果:1.PSA-SLeX在前列腺癌與前列腺增生中均有表達(dá),但在前列腺癌中呈高表達(dá)水平,兩者之間表達(dá)量有顯著差異(P=0.000)。2.應(yīng)用ROC曲線可以得出,PSA-SLeX與TPSA的曲線下面積(AUC)分別為0.851和0.815;熒光探針SLeX與在TPSA前列腺癌中的診斷價值相當(dāng)(P0.05)。血清PSA-SLeX與TPSA在前列腺癌實驗中診斷最佳臨界值(即cutoff值)分別為13.15ng/ml和 9.68ng/ml。3.前列腺癌TNM分期中,非局限組中PSA-SLeX表達(dá)濃度較TPSA濃度高,差異有統(tǒng)計學(xué)意義(P=0.001)。4.前列腺癌Gleason評分分組中,在中、低分化前列腺癌組間血清中PSA-SLeX表達(dá)濃度較TPSA要高,比較差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:熒光探針SLeX用于臨床前列腺癌的篩查時,在前列腺癌TNM分期的中晚期及Gleason評分分組的中、低分化的陽性檢出率優(yōu)于TPSA的陽性檢出率。
[Abstract]:Objective: to establish a new method for the diagnosis of prostate cancer by using fluorescent probe SLeX(Sialyl-Lewis X, salivary acidified Lewis oligosaccharide X antigen to detect serum samples, and to improve the early diagnosis rate of prostatic carcinoma. To evaluate the value of fluorescent probe SLeX in the diagnosis of prostate cancer and its significance in clinical TNM staging, pathological grading and Gleason score. Methods: from January 2015 to December 2016, 76 patients in urology department of affiliated Hospital of Hebei University were selected, including 38 patients with benign prostatic hyperplasia (BPH) and 38 patients with prostate cancer (group PCA). Both groups were diagnosed by prostate puncture or / and postoperative pathology. According to the 2002 AJCC TNM staging, prostate cancer patients were divided into two groups: localized group (n = 16) and nonlocalized group (n = 22). According to the Gleason score, they were classified as well-differentiated carcinoma and poorly differentiated carcinoma, respectively. There were 12 cases of poorly differentiated carcinoma, 10 cases of carcinoma and 16 cases of carcinoma. The expression of PSA-SLeX (prostate-specific saliva acidified Lewis oligosaccharide X antigen) in serum was detected by using fluorescent probe SLeX as antibody and ELISA assay (enzyme-linked immunosorbent assay). The expression of TPSA in serum was detected by double antibody sandwich method, and the value of the two detection methods in the diagnosis of prostate cancer and the clinical TNM staging were compared and analyzed. The feasibility and significance of pathological grading and Gleason score. Results 1. PSA-SLeX was expressed in both prostate cancer and prostatic hyperplasia, but it was highly expressed in prostate cancer. There was a significant difference in the expression of PSA-SLeX between the two groups. The area under the curve of PSA-SLeX and TPSA was 0.851 and 0.815 respectively by using ROC curve. The diagnostic value of fluorescence probe SLeX was similar to that of TPSA in the diagnosis of prostate cancer. The best critical value (cutoff value) for serum PSA-SLeX and TPSA in prostate cancer test was 13.15ng/ml and 9.68 ng / ml. 3 respectively. In the TNM stage of prostate cancer, the PSA-SLeX expression level in the non-localized group was higher than that in the TPSA group, and the difference was statistically significant. In the Gleason score group of prostate cancer, the expression of PSA-SLeX in the serum of low differentiated prostate cancer patients was higher than that of TPSA, and the difference was statistically significant (P 0.05). Conclusion: when the fluorescent probe SLeX is used in clinical prostate cancer screening, the positive rate of low differentiation is better than that of TPSA in the middle and late stages of TNM stage and in the Gleason score group of prostate cancer.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.25

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