RT-PCR检测前列腺癌患者PSMA mRNA表达的临床意义

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目的应用巢氏逆转录聚合酶链反应(RT-PCR)检测前列腺癌(PCa)患者外周血前列腺特异性膜抗原mRNA(PSMA mRNA)的表达并探讨其临床应用意义。方法采用巢氏RT-PCR检测28例PCa患者、20例前列腺增生(BPH)患者和10例健康男性外周血中PSMA mRNA的表达情况。结果28例PCa患者中PSMA mRNA表达阳性18例,20例BPH患者和10例健康男性均为阴性,检测灵敏度为64.29%,特异性为100.00%。18例接受内分泌治疗的患者中PSMA mRNA表达阳性13例,阳性率为72.22%,未接受内分泌治疗的患者阳性率为40.00%。PSMA mRNA与前列腺特异性抗原(PSA)水平具有明显相关性,随着PSA水平的升高PSMA mRNA阳性率也随之升高,各组间比较差异有统计学意义(P<0.05)。PSMA mRNA与PCa的临床分期也有明显的相关性,D期PCa患者的PSMA mRNA阳性率明显高于B、C期,差异有统计学意义(P<0.05)。PSMA mRNA与PCa的病理分期无明显相关性。PSMA mRNA与PCa的转移有明显的相关性,己出现骨转移者PSMA mRNA阳性率明显升高,差异有统计学意义(P<0.05)。结论巢氏RT-PCR检测PCa患者外周血中PSMA mRNA表达的方法是一种十分有应用价值的诊断PCa及监测PCa微转移的方法,特别是对接受过内分泌治疗的患者,检测PSMA mRNA要比PSA mRNA更有意义。 Objective To detect the expression of prostate specific membrane antigen mRNA (PSMA mRNA) in peripheral blood of patients with prostate cancer (PCa) by reverse transcription polymerase chain reaction (RT-PCR) and to explore its clinical significance. Methods Nestin RT-PCR was used to detect the expression of PSMA mRNA in 28 cases of PCa, 20 cases of BPH and 10 cases of healthy male. Results The positive expression of PSMA mRNA in 28 cases of PCa was 18 cases, 20 cases of BPH and 10 cases of healthy male were negative. The detection sensitivity was 64.29% and the specificity was 100.00%. In 18 patients with endocrine therapy PSMA mRNA expression was positive in 13 cases, the positive rate was 72.22%, did not receive endocrine therapy in patients with positive rate of 40.00%. There was a significant correlation between PSMA mRNA and prostate specific antigen (PSA) level. With the increase of PSA level, the positive rate of PSMA mRNA also increased, with significant difference between the groups (P <0.05). There was also a significant correlation between PSMA mRNA and the clinical stage of PCa. The positive rate of PSMA mRNA in stage D PCa was significantly higher than that in stage B and C (P <0.05). PSMA mRNA and PCa pathological staging no significant correlation. There was a significant correlation between the expression of PSMA mRNA and PCa. The positive rate of PSMA mRNA in bone metastases was significantly increased (P <0.05). Conclusion The method of detecting the expression of PSMA mRNA in peripheral blood of PCa patients by RT-PCR is a very valuable method to diagnose PCa and monitor the micrometastasis of PCa. Especially for patients who have undergone endocrine therapy, PSA mRNA makes more sense.
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