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目的探讨尿前列腺癌基因3(PCA3)评分在前列腺癌的诊断意义。方法选取前列腺直肠指诊异常的受检者82例作为观察组,另选取30例同期健康查体者作为对照组。检测两组尿液中前列腺特异抗原(PSA)和PCA3 m RNA的表达并计算尿PCA3评分,观察组均行超声引导下穿刺检查确定前列腺癌发生情况,并采用ROC曲线分析尿PCA3评分诊断前列腺癌的准确性。结果观察组的尿PSA m RNA、PCA3 m RNA及PCA3评分分别为(490.12±373.42)、(62.52±54.16)和(159.85±118.78)分,高于对照组的(352.42±326.62)、(4.21±4.03)和(11.95±6.25)分,差异有统计学意义(P<0.05)。观察组确诊为良性前列腺增生、前列腺癌的患者比例分别为43.90%和56.10%,前列腺癌患者尿PSA m RNA、PCA3 m RNA及PCA3,差异有统计学意义(P<0.05),而良性前列腺增生患者和对照组尿PSA m RNA、PCA3 m RNA及PCA3评分比较,差异均无统计学意义(P>0.05)。尿PCA3评分经ROC曲线分析,其ROC-AUC=0.893[95%CI(0.834,0.942)],本研究中以截断值65为前列腺癌诊断的临界值时截断值以上有41例前列腺癌患者,敏感性为89.13%,截断值以下63例良性前列腺增生患者和健康人群,特异性为95.45%,阳性预测值和阴性预测值分别为93.18%和92.65%,尿PCA3评分诊断前列腺癌发生的价值良好。结论尿PCA3评分在前列腺癌患者中的水平较高且其截断值为65时诊断前列腺癌可获得较高的诊断价值,因此尿PCA3评分可能作为前列腺癌诊断的参考指标之一。
Objective To investigate the diagnostic value of urine prostatic cancer 3 (PCA3) score in prostate cancer. Methods Totally 82 subjects with abnormal prostatic rectal examination were selected as the observation group and 30 healthy people with the same period as the control group. The expression of prostate specific antigen (PSA) and PCA3 mRNA in urine of two groups were detected and the urinary PCA3 score was calculated. In the observation group, the incidence of prostate cancer was determined by puncture under ultrasound guidance. Urinary PCA3 score was analyzed by ROC curve to diagnose prostate cancer Accuracy Results The urinary PSAmRNA, PCA3mRNA and PCA3 scores in the observation group were (490.12 ± 373.42), (62.52 ± 54.16) and (159.85 ± 118.78) points higher than those in the control group (352.42 ± 326.62) and (4.21 ± 4.03) and (11.95 ± 6.25) points, the difference was statistically significant (P <0.05). The proportion of patients with benign prostatic hyperplasia and prostate cancer in the observation group was 43.90% and 56.10% respectively, and the difference was statistically significant (P <0.05) between the patients with prostatic cancer and those with PCa3 and m RNA There was no significant difference in urinary PSA m RNA, PCA3 m RNA and PCA3 scores between patients and controls (P> 0.05). Urine PCA3 score by ROC curve analysis, the ROC-AUC = 0.893 [95% CI (0.834,0.942)], in this study with a cut-off value of 65 for the cut-off value of prostate cancer diagnosis cut-off value of 41 cases of prostate cancer patients, The sensitivity was 89.13%, the specificity was 95.45% in 63 patients with benign prostatic hyperplasia and healthy population, the positive predictive value and negative predictive value were 93.18% and 92.65% respectively. The value of urinary PCA3 score in diagnosing prostate cancer was good . Conclusions The urinary PCA3 score is higher in patients with prostate cancer and the diagnostic value of PCA3 is higher when the cut-off value is 65. Therefore, the urinary PCA3 score may serve as one of the reference indexes for the diagnosis of prostate cancer.