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目的探讨前列腺特异性膜抗原(PSMA)在前列腺癌患者(PCa)外周血和组织中的表达及其与肿瘤病理分级和临床分期之间的关系。方法采用RT-PCR方法检测前列腺特异性膜抗原(PSMA)在前列腺癌和良性增生患者外周血清中的表达;采用免疫组化法观察PSMA在前列腺不同病变组织中的表达。前列腺癌28例,前列腺上皮内瘤(PIN)7例,良性前列腺增生(BPH)30例。结果血清学检测显示PSMA mRNA在前列腺癌和良性病变组(包括PIN和BPH)患者外周血中阳性率分别为67.9%和8.1%,两者差异具有显著性(P<0.01)。在局限性癌、局部进展性癌和远处转移癌患者外周血肿瘤细胞中,PSMA mRNA的阳性率分别为58.3%、66.7%和85.7%,随前列腺癌临床分期的进展而逐渐递增(P<0.05)。在高分化、中分化和低分化前列腺癌中,PSMA mRNA的阳性率分别为87.5%、62.5%和50%,肿瘤分化越差,其阳性率越低(P<0.05)。组织学检测显示PSMA在PCa、PIN、BPH三种不同前列腺病变组织中的阳性率分别为60.7%、28.6%和20.0%(P<0.05),在高、中、低分化前列腺癌组织中PSMA的阳性率分别为100.0%、50.0%和25.0%,与肿瘤Gleason评分之间呈负相关(P<0.05)。在局限性癌、局部进展性癌和远处转移癌患者肿瘤组织中,PSMA的阳性率分别为58.3%(7/12)、77.8%(7/9)和42.9%(3/7)(P>0.05)。结论PSMA在前列腺癌组织中明显高表达,并且表达量与前列腺癌临床分期和分化程度(组织学分级)密切相关;检测PSMA可能对前列腺癌诊断、治疗方案的选择及预后评估具有重要价值。
Objective To investigate the expression of prostate-specific membrane antigen (PSMA) in peripheral blood and tissues of patients with prostate cancer (PCa) and its relationship with tumor pathological grade and clinical stage. Methods The expression of PSMA in peripheral blood of patients with benign prostatic hyperplasia and benign prostatic hyperplasia was detected by RT-PCR. The expression of PSMA in different tissues of prostate was observed by immunohistochemistry. 28 cases of prostate cancer, 7 cases of prostatic intraepithelial neoplasia (PIN) and 30 cases of benign prostatic hyperplasia (BPH). Results Serological tests showed that the positive rates of PSMA mRNA in peripheral blood of patients with prostate cancer and benign lesions (including PIN and BPH) were 67.9% and 8.1% respectively, with significant difference (P <0.01). The positive rates of PSMA mRNA were 58.3%, 66.7% and 85.7% in peripheral blood tumor of patients with localized cancer, locally advanced cancer and distant metastasis respectively, which gradually increased with the clinical stage of prostate cancer (P < 0.05). In well differentiated, moderately differentiated and poorly differentiated prostate cancer, the positive rates of PSMA mRNA were 87.5%, 62.5% and 50%, respectively. The positive rate of PSMA mRNA was lower (P <0.05). Histological examination showed that the positive rates of PSMA in PCa, PIN and BPH tissues were 60.7%, 28.6% and 20.0%, respectively (P <0.05). The positive rates of PSMA in high, moderate and poorly differentiated prostate cancer tissues The positive rates were 100.0%, 50.0% and 25.0%, respectively, which were negatively correlated with the Gleason score (P <0.05). The positive rates of PSMA were 58.3% (7/12), 77.8% (7/9) and 42.9% (3/7) respectively in the tumor tissues of patients with localized cancer, locally advanced cancer and distant metastasis > 0.05). Conclusions PSMA is highly expressed in prostate cancer tissues, and its expression level is closely related to the clinical stage and degree of differentiation (histological grade) of prostate cancer. Detection of PSMA may be of great value in the diagnosis and treatment of prostate cancer and the evaluation of prognosis.