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目的:了解前列腺癌患者mtDNA突变频率以及其对前列腺癌恶性程度的影响。方法:选2006年10月～2008年3月经历前列腺穿刺活检或前列腺癌根治的130例前列腺癌患者作为研究组,年龄60～97(70.1±2.4)岁;26例前列腺增生患者为对照组,年龄60～92(69.8±2.1)岁。采用PCR方法检测前列腺组织线粒体DNA4977(mtDNA~(4977))缺失率,对所有患者进行组织病理学Gleason评分。结果:研究组98例发生mtDNA~(4977)缺失(75.4%),对照组3例发生mtDNA~(4977)缺失(11.5%),差异有统计学意义(P<0.01)。前列腺癌组发生mtDNA~(4977)突变的患者Gleason评分(7.6±2.4)显著高于无突变患者(6.2±1.1,P<0.01)。应用对数回归分析证实Gleason评分(OR=1.452,95%CI:1.149-1.833)与年龄(OR=1.086,95%CI:1.010-1.167)是mtDNA~(4977)缺失突变的独立预测因子,敏感性和特异性分别是75.4%和88.5%,准确率为78%(121/156),代表mtDNA~(4977)缺失的ROC曲线下面积为0.82。结论:mtDNA~(4977)缺失突变率可能对辨别前列腺增生和前列腺癌有帮助,可作为前列腺癌恶性程度评估的一个生物标记物。
Objective: To understand the frequency of mtDNA mutation in prostate cancer patients and its effect on the malignancy of prostate cancer. Methods: A total of 130 prostate cancer patients who underwent prostate biopsy or radical prostatectomy from October 2006 to March 2008 were selected as the study group, ranging in age from 60 to 97 (70.1 ± 2.4) years. 26 patients with benign prostatic hyperplasia Aged 60 ~ 92 (69.8 ± 2.1) years old. The deletion rate of mitochondrial DNA4977 (mtDNA ~ (4977)) in prostatic tissue was detected by PCR, and histopathological Gleason score was applied to all patients. Results: The mtDNA ~ (4977) deletion (75.4%) was found in 98 cases of the study group and the loss of mtDNA ~ (4977) was 11.5% in the control group. The difference was statistically significant (P <0.01). The Gleason score (7.6 ± 2.4) in patients with prostate cancer who underwent mtDNA ~ (4977) mutation was significantly higher than that in patients without mutation (6.2 ± 1.1, P <0.01). Logistic regression analysis confirmed that Gleason score (OR = 1.452, 95% CI: 1.149-1.833) and age (OR = 1.086,95% CI: 1.010-1.167) were independent predictors of mtDNA ~ (4977) deletion mutation and were sensitive The specificity and specificity were 75.4% and 88.5%, respectively. The accuracy was 78% (121/156). The area under the ROC curve representing the deletion of mtDNA 4977 was 0.82. CONCLUSION: The mutation rate of mtDNA ~ (4977) may be helpful to distinguish between benign prostatic hyperplasia and prostate cancer, which may be used as a biomarker to evaluate the malignancy of prostate cancer.