摘要
目的:探讨血清腺激肽释放酶2(hK2)、甲基酰基辅酶A消旋酶(AMACR)联合前列腺特异性抗原(PSA)检测对前列腺癌诊断及预后判断的临床价值。方法:前瞻性选取2016年01月至2018年01月收治的前列腺癌患者50例为前列腺癌组和良性前列腺增生患者50例为良性前列腺增生组。并以同期健康查体者50例为对照组。检测比较三组血清hK2、AMACR和PSA水平,Logistic分析血清hK2、AMACR和PSA水平对前列腺癌发生状况的影响,ROC曲线分析血清hK2、AMACR和PSA水平联合检测对前列腺癌的诊断效能。对前列腺癌组进行为期3年的随访,记录患者复发和生存情况。比较不同复发和生存预后情况患者的基线血清hK2、AMACR和PSA水平,Logistic分析基线血清hK2、AMACR和PSA水平对前列腺癌患者复发和生存预后的影响,ROC曲线分析血清hK2、AMACR和PSA水平联合检测对前列腺癌患者复发和死亡早期评估效能。结果:前列腺癌组血清hK2、AMACR水平高于良性前列腺增生组和对照组(P<0.05);而良性前列腺增生组和对照组血清hK2、AMACR水平比较差异无统计学意义(P>0.05)。前列腺癌组、良性前列腺增生组和对照组的血清PSA水平依次降低(P<0.05)。Logistic分析结果显示,血清hK2、AMACR和PSA水平对前列腺癌发生状况具有明显影响(P<0.05)。ROC曲线分析结果显示血清hK2、AMACR和PSA水平联合检测对前列腺癌具有良好的诊断效能。前列腺癌组50例患者的3年复发率和生存率分别为56%(28/50)和52%(26/50)。前列腺癌组复发患者的血清hK2、AMACR和PSA水平均高于未复发患者(P<0.05);且前列腺癌组死亡患者的血清hK2、AMACR和PSA水平均高于存活患者(P<0.05)。Logistic分析结果显示,血清hK2、AMACR和PSA水平均受到前列腺癌患者复发和生存预后的影响(P<0.05)。ROC曲线分析结果显示血清hK2、AMACR和PSA水平联合检测对前列腺癌患者复发和死亡均具有良好的早期评估效能。结论:血清hK2、AMACR和PSA水平在前列腺癌患者中表达水平较高,具有一定的前列腺癌诊断价值,且可能作为预后早期预测的有效参考指标。
Objective:To explore the clinical value of serum glandular kallikrein 2(hK2),methylacyl-CoA racemase(AMACR)combined with prostate specific antigen(PSA)in the diagnosis and prognosis of prostate cancer.Methods:50 cases of prostate cancer patients admitted from January 2016 to January 2018 were prospectively selected as the prostate cancer group and 50 patients with benign prostatic hyperplasia admitted in the same period were selected as the benign prostatic hyperplasia group.In addition,50 cases of persons had healthy physical examinations during the same period served as the control group.Serum hK2,AMACR and PSA levels of the 3 groups were tested and compared.The Logistic method was applied in analysis of the effect of serum hK2,AMACR and PSA levels on the occurrence of prostate cancer.ROC curve was applied in analysis of the combined detection of serum hK2,AMACR and PSA levels for the diagnosis of prostate cancer.The prostate cancer group was followed up for 3 years to record the recurrence and survival of the patients.The baseline serum hK2,AMACR and PSA levels of patients with different recurrence and survival prognosis were compared.The Logistic method was applied in analysis of the impact of baseline serum hK2,AMACR and PSA levels on the prognosis of prostate cancer recurrence and survival.ROC curve was applied in analysis of the effectiveness of combined detection of serum hK2,AMACR and PSA levels to early evaluate the prostate cancer recurrence and death.Results:The serum hK2 and AMACR levels of the prostate cancer group were higher than those of the benign prostatic hyperplasia group and the control group(P<0.05).While the serum hK2 and AMACR levels of the benign prostatic hyperplasia group and the control group were not significantly different(P>0.05).Serum PSA levels in the prostate cancer group,benign prostatic hyperplasia group,and control group decreased sequentially(P<0.05).Logistic analysis showed that serum hK2,AMACR and PSA levels had a significant impact on the occurrence of prostate cancer(P<0.05).ROC curve analysis results showed that the combined detection of serum hK2,AMACR and PSA levels had a good diagnostic efficiency for prostate cancer.The 3-year recurrence rate and survival rate of 50 patients in the prostate cancer group were 56%(28/50)and 52%(26/50)respectively.The serum hK2,AMACR,and PSA levels of patients with recurrence in the prostate cancer group were higher than those of patients without recurrence(P<0.05).And the serum hK2,AMACR,and PSA levels of patients who died in the prostate cancer group were higher than those of surviving patients(P<0.05).Logistic analysis showed that serum hK2,AMACR and PSA levels were significantly affected by the recurrence and survival prognosis of prostate cancer(P<0.05).ROC curve analysis results showed that the combined detection of serum hK2,AMACR and PSA levels had a good early evaluation performance for prostate cancer recurrence and death.Conclusion:Serum hK2,AMACR and PSA levels are high in prostate cancer patients,which have certain diagnostic value for prostate cancer,and may be used as effective reference indicators for early prognosis prediction.
作者
赖飞
黄朝友
钱友良
蔡勇
高云峰
刘俊波
LAI Fei;HUANG Chaoyou;QIAN Youliang;CAI Yong;GAO Yunfeng;LIU Junbo(Department of Urology,the Second People's Hospital of Chengdu,Sichuan Chengdu 610021,China)
出处
《现代肿瘤医学》
CAS
北大核心
2022年第16期3008-3013,共6页
Journal of Modern Oncology
基金
四川省科技计划项目(编号:2018JDR3369)。
