外周血差异显示编码3mRNA定量检测在前列腺癌患者诊断与治疗监测中的初步应用

目的探讨外周血差异显示编码3（DD3）mRNA定量检测在前列腺癌诊断和治疗监测中意义。方法用荧光定量逆转录聚合酶链反应（FQ—RT—PCR）方法对35例未治疗前列腺癌、58例内分泌治疗后前列腺癌、59例良性前列腺增生患者和10例健康男性志愿者外周血DD3mRNA含量进行定量检测,并对DD3mRNA诊断及疗效监测价值进行评价。结果未治疗前列腺癌组外周血DD3mRNA含量明显高于治疗后前列腺癌组、前列腺增生组和健康男性志愿者组,差异具有统计学意义（P〈0．01）。未治疗前列腺癌患者随着临床分期增加,外周血DD3mRNA含量也增高,差异具有统计学意义（P〈0．01）。当临界值为846拷贝／ml时,DD3mRNA曲线下面积为0．822（95％CI：0．725～0．919）,灵敏度、特异度分别为74．3％、89．8％。结论外周血DD3mRNA定量检测是前列腺癌诊断的良好指标,可作为内分泌治疗过程疗效监测的指标。

Quantitative detection of differential display code 3 mRNA in peripheral blood of patients with prostate cancer

Objective To investigate the expression of DD3 mRNA in the peripheral blood and its value in diagnostic of prostate cancer (Pca). Methods Thirty-five untreated Pca patients, aged 72 (53-83), 58 Pca patients treated with endocrinotherapy, aged 74 (53-86), and 59 patients with benign prostatic hyperplasia, aged 71 (48-85), underwent peripheral blood sample collection one week before or after digital examination. RT-PCR was used to examine the level of DD3 mRNA. The level of prostate specific antigen (PSA) was detected too. Ten healthy male frontiers, aged 33 (21-38), were used as controls. Receiver operating curve (ROC) was drawn to evaluate the diagnostic performance of DD3 mRNA. Results The DD3 mRNA level of the untreated Pca patients was 2741 copies/ml, significantly higher than those of the Pca patients treated with endocrinotherapy, patients with benign hyperplasia, and healthy persons (all <24 copies, all P<0.001). The DD3 mRNA level of the endocrinotherapy-treated Pca patients was significantly higher than those of the patients with benign hyperplasia, and healthy persons (both P<0.001). ROC analysis showed that when the critical value was 846 copies/ml the area under curve of ROC (AUC-ROC) was 0.8233 (95% CI: 0.725-0.910). and the sensitivity was 74.34%, the specificity was 89.8%. The DD3 mRNA in the peripheral blood increased along with the increase of clinical staging (P<0.01). Conclusion The level of DD3 mRNA in the peripheral blood is an excellent marker for diagnosis pf Pca, and may help in monitoring of the curative effects of endocrinotherapy.