良性前列腺增生及前列腺癌的ADC值与PAP、P504S、PSA表达的相关性研究

目的：探讨良性前列腺增生和前列腺癌的ADC值与前列腺相关标志物PAP、P504S、PSA表达的关系。方法收集经病理证实的65例前列腺疾病患者，其中良性前列腺增生30例，前列腺癌35例。病理检查前3个月内均行前列腺MRI、DWI检查，采用单次激发EPI序列，b值为0 s/mm2和800 s/mm2，并采用免疫组化检测组织标本中PAP、P504S、PSA的表达，分析ADC值与PAP、P504S、PSA表达的关系。结果良性前列腺增生和前列腺癌的ADC值分别为（1.73±0.21）×10-3 mm2/s和（1.34±0.15）×10-3 mm2/s，差异具有统计学意义（t=8.545，P=0.000）。PAP和PSA在良性前列腺增生和前列腺癌中均表达，差异无统计学意义（P均＞0.05），P504S在前列腺癌中的表达显著高于良性增生（Z=-7.055，P=0.000），双变量相关分析显示ADC值与P504S的表达呈显著负相（Spearman's相关系数r=-0.654，P=0.000）；结论 PAP和PSA不能区别前列腺良恶性病变；P504S可以作为前列腺癌标志物；ADC值可以定量评价良性前列腺增生和前列腺癌，且与P504S存在负相关，可以作为前列腺良恶性病变MRI诊断的参考指标。

Correlation of the expression of PAP,P504S,PSA with the apparent diffusion coefficient in benign prostatic hyperplasia and prostate cancer

Objective To investigate the correlation between apparent diffusion coefficient (ADC) and PAP, P504S, PSA expression in benign prostatic hyperplasia (BPH) and prostate cancer (Pca). Method 65 cases of pros-tate lesions confirmed pathologically were included in this study, in which there were 30 cases of BPH and 35 cases of Pca. DWI (b-values=0 s/mm2 and 800 s/mm2) images were obtained for all cases by Siemens Sonata 1.5T and the expression of PAP, P504S, PSA were detected with SP immunohistochemical technique individually. Result The mean ADC values of BPH and Pca were (1.73±0.21)×10-3 mm2/s and (1.34±0.15)×10-3 mm2/s, which were significantly different (t=8.545 ,P=0.000). The expression of PAP and PSA were both observed in BPH and Pca, with no signifi-cant difference appeared (both P>0.05). The expression of P504S in Pca was apparently higher than that in BPH (Z=-7.055, P=0.000), and the bivariate analysis showed that ADC was negatively correlated with P504S (Spearman ’s correlation coefficient r=-0.654, P=0.000). Conclusion PAP and PSA can't be applied in distinguishing benign and malignant lesions of prostate. P504S is supposed to be a specific biomarker for prostate cancer. ADC value is essen-tial in quantitatively evaluating the differences of BPH and Pca, and it negatively correlates with P504S, making it an important reference in MRI diagnosis of benign and malignant lesions of prostate.