TrACP在诊断和预测前列腺癌骨转移中的临床意义

目的研究抗酒石酸酸性磷酸酶在前列腺骨转移患者血清中的变化,探讨其用来诊断和预测前列腺发生骨转移的临床意义。方法以78例前列腺癌患者以及40例良性前列腺增生患者为研究对象,分为前列腺癌骨转移患者组41例(A组),前列腺癌无骨转移患者组37例(B组),良性前列腺增生患者组40例(C组),同时以40例健康青壮年男性作为健康对照组40例(D组)。应用双抗体夹心酶标免疫分析法测定患者血清标本中的Tr ACP水平,结合病理分级、Gleason评分、PSA、ALP和ALT等进行统计学分析。结果骨转移患者的血清Tr ACP浓度明显高,与其他各组比较差异具有显著性;血清Tr ACP浓度与PSA水平有较强的正相关性;ROC曲线下面积(AUC)均大于ALP和ALT,且Tr ACP与PSA的ROC曲线交叉,提示对骨转移的诊断价值较高。结论Tr ACP的检测对于前列腺癌骨转移具有更直接的诊断价值和预测价值,通过监测前列腺癌患者的血清Tr ACP含量,对了解前列腺癌的生长状态、判断病程进展、预测骨转移的发生具有重要的临床意义。     

CD326在前列腺癌组织高表达且与患者预后负相关

目的在正常前列腺、前列腺增生及前列腺癌组织中检测CD326的表达差异及与前列腺癌预后的相关性。方法采用免疫组织化学技术检测组织芯片(含6例正常前列腺组织、24例前列腺增生组织以及210例前列腺癌组织)的CD326的表达,Western blot法检测4例前列腺癌及癌旁组织中CD326的表达。统计学分析组织芯片中CD326的表达水平与前列腺癌患者的总生存期及无转移生存期的相关性。结果免疫组织化学染色结果显示:与正常前列腺及前列腺两性增生的组织相比,前列腺癌组织中CD326的表达显著增强,Western blot结果进一步证实CD326在前列腺癌组织中的水平显著高于癌旁组织中的水平。CD326在前列腺癌组织中的表达与前列腺癌的临床分期、转移及血清前列腺特异性抗原(PSA)水平呈显著正相关,CD326高表达的前列腺癌患者其总生存期和无转移生存期显著低于CD326低表达的患者。结论 CD326在前列腺癌组织中高表达且与前列腺癌患者的血清PSA水平及预后负相关。     

PSA、SPECT骨显像在前列腺癌诊断和治疗中的临床价值

目的:探讨PSA、SPECT骨显像在前列腺癌诊断及治疗中的临床应用.方法:对72例经临床确诊的前列腺癌患者全部行血清PSA测定及全身骨显像,并对部分患者治疗后进行了随访.结果:前列腺癌组PSA明显高于正常对照组、良性前列腺疾病组;前列腺癌骨转移组PSA明显高于非骨转移组;72例前列腺癌初诊患者骨显像发现24例骨转移瘤,阳性率33.3%.结论:血清PSA与骨显像联检对前列腺癌临床诊断、疗效观察及预后判定具有重要的指导意义.     

PSA、cPSA检测和骨显像对前列腺癌早期骨转移的诊断价值

目的:分析前列腺特异性抗原(PSA)、复合前列腺特异性抗原(cPSA)联检和核素全身骨显像对前列腺癌早期骨转移的诊断价值.方法:选择152例患者(其中74例为临床确诊的前列腺癌患者,78例为良性前列腺疾病患者),全部进行血清PSA、cPSA检测,并同时对74例临床确诊的前列腺癌患者进行核素全身骨显像.另选择正常健康查体男性90例检测血清PSA、cPSA结果作为对照组.并计算cPSA/PSA比值.结果:前列腺癌患者血清PSA、cPSA检测结果及cPSA/PSA比值显著高于良性前列腺疾病患者及正常健康男性.其中,骨转移阳性显像组血清PSA、cPSA水平及cPSA/PSA比值显著高于非骨转移显像组,检测存在显著性差异(P＜0.05).结论:当PSA＞20μg/L、cPSA＞10μg/L、cPSA/PSA＞0.80时,发生前列腺癌骨转移的可能性较大,应常规做核素全身骨显像,可早期、全面地发现前列腺癌骨转移.     

血清PSA、ALP检测和核素骨显像诊断前列腺癌早期骨转移

目的:探讨早期明确前列腺癌骨转移的有效方法。方法:选择45例前列腺增生患者作为对照组,用化学发光免疫分析法检测PSA;酶法检测单脂磷酸水解酶(ALP即AKP);用SPECT对38例前列腺癌患者进行全身核素骨显像的同时,测定血清PSA、ALP。结果:有骨转移的Pca患者的血清PSA和ALP浓度明显高于无骨转移及前列腺增生(BHP)患者;骨显像阳性组和骨显像阴性组分别与前列腺增生组比较,PSA有极显著性意义(P<0. 001);ALP测定阳性组与增生组比较有显著性意义(P<0. 001),阴性组与增生组比较无显著性意义(P>0. 05)。结论:同时测定血清PSA和ALP有助于明确前列腺癌患者核素骨显像异常表现的病变性质。     

前列腺癌患者根治术后首次血清 PSA 水平及影响因素分析

目的:研究前列腺癌患者根治术后首次血清前列腺特异性抗原(Prostate-specific antigen,PSA)水平及其影响因素.方法:选取我院2018年11月至2021年1月收治的110例前列腺癌患者,比较手术前及手术6 w后首次血清PSA水平;根据患者手术6w后PSA水平分为PSA<0.2 ng?mL-1组和PSA≥0.2 ng?mL-1组,采用Logistic回归模型分析影响前列腺癌患者根治术后首次血清PSA水平的独立危险因素.结果:患者术后血清PSA水平明显低于术前;吸烟史、Gleason评分、病理分期、有无淋巴结清扫、术前有无电切为影响前列腺癌患者根治术后首次PSA水平的单因素(P<0.05).Logistic回归模型分析显示:Gleason评分(8～10分)、病理分期(进展期)、有无淋巴结清扫(有)、术前有无电切(有)为影响前列腺癌患者根治术后首次PSA水平的独立危险因素(P<0.05).结论:前列腺癌患者根治术后首次血清PSA水平普遍下降,其中Gleason评分、病理分期、有无淋巴结清扫、术前有无电切为影响其首次PSA水平的独立危险因素.     

放射性核素骨显像联合PSA、fPSA、fPSA/tPSA评价前列腺癌骨转移

目的:评价前列腺癌患者放射性核素骨显像与血清前列腺特异抗原测定的诊断价值.方法:随机选择前列腺癌患者骨显像示骨转移与骨显像正常患者各35例,前列腺良性病患者30例及健康体检者35例,分别测定其血清中PSA、fPSA、fPSA/tPSA的含量.结果:前列腺癌无骨转移组PSA、fPSA水平较对照组略有升高,但皆无显著性差异...     

不同级别前列腺癌中HKⅡ和PSA的表达及临床意义

目的 探讨不同级别前列腺癌中己糖激酶Ⅱ(hexokinaseⅡ, HKⅡ)和前列腺特异性抗原(prostate specific antigen, PSA)的表达。方法 收集35例正常前列腺组织及189例前列腺癌手术标本,在HE染色下根据危险程度将前列腺癌分为低级别和高级别组,应用免疫组化EnVision两步法染色检测HKⅡ和PSA在不同前列腺组织中的表达,并分析HKⅡ和PSA表达与前列腺癌临床病理学特征的关系及两者的相关性。结果 HKⅡ在正常前列腺组织(14.3%)、低级别前列腺癌(52.7%)及高级别前列腺癌(74.0%)的高表达率逐渐升高(P<0.05);在189例前列腺癌中,HKⅡ表达与Gleason评分、组织学分级及分期有关(P<0.05)。与正常前列腺组织(37.1%)相比,PSA在前列腺癌中(96.3%)的高表达率明显升高(P<0.05)。前列腺癌中HKⅡ与PSA表达呈正相关(P=0.019)。结论 HKⅡ和PSA在前列腺癌中高表达,随着前列腺癌的进展,HKⅡ的高表达率呈逐渐升高的趋势,且HKⅡ和PSA表达呈显著相关性,提示HKⅡ联合PSA检测有望成为前...     

CLIA法检测血清PSA在前列腺疾病诊断中的临床价值

评价血清前列腺特异性抗原 (PSA)在前列腺癌与前列腺增生症 (BPH)鉴别诊断中的意义。采用化学发光免疫法 (CLIA)检测 10名健康志愿者、2 3例前列腺癌患者、6 1例BPH患者、11例BPH伴急性尿潴留患者血清PSA。对其中 16例前列腺癌患者进行 1- 6个月随访检测。结果 :① 10名正常志愿者血清PSA均小于 4μg/L ;前列腺癌组血清PSA明显升高 ,BPH组及BPH伴急性尿潴留组血清PSA亦高于正常 ,后三组间在统计学上均有显著差异性 (P <0 .0 1)。②CLIA法检测血清PSA的鉴别诊断阈值以 2 0 μg/L为低限。③ 16例前列腺癌患者术后 1个月内血清PSA均下降。其中 14例病情稳定者血清PSA下降至正常 ,2例病情恶化者术后 3个月血清PSA迅速回升。血清PSA对鉴别诊断前列腺良、恶性疾病具有重要价值 ,有助于前列腺癌疗效的预测及预后的判断     

老年人PSA水平与前列腺疾病的关系研究

目的:观察老年男性血清PSA水平与前列腺疾病的相关性.方法:采用放射免疫分析,分别对845例老年人和前列腺良性疾患与前列腺癌病人进行了血清PSA的检测,并与40例正常人比较.结果:老年体检组中各年龄段的血清PSA平均水平明显升高,显著高于正常对照组(P＜0.01);前列腺癌患者血清PSA水平显著高于前列腺良性疾患组和正常对照组(P＜0.01),前列腺良性疾患组又明显高于正常对照组(P＜0.01).结论:检测老年男性血清PSA水平有助于鉴别诊断前列腺癌和前列腺良性疾病及泌尿系统等疾病,但PSA不能成为唯一诊断前列腺癌的血清学指标.     

miRNA-15a 在前列腺癌中的表达及诊断意义

目的:检测前列腺癌患者miRNA-15a 的表达情况,探讨其在前列腺癌诊断的意义。方法:选择2014 年1 月至2015 年1 月本院泌尿外科收治的前列腺癌患者血清及肿瘤组织36 例,良性前列腺增生患者(Prostatic hyperplasia,BPH)血清40 例,健康对照血清40 例。miRNA鄄15a 表达采用实时定量聚合酶链反应(Real鄄time PCR)技术检测。结果:miRNA-15a 在前列腺癌患者、良性前列腺增生患者和健康对照血清的表达量分别为(0.193±0.081)、(0.359±0.04)和(0.376±0.037),miRNA-15a 在前列腺癌患者血清中的表达量显著低于良性前列腺增生患者和健康对照(P<0.05),在BPH 组和对照组中的表达差异无统计学意义(P>0.05),前列腺癌患者血清miRNA-15a 表达在不同PSA 表达水平、Gleason 评分、临床分期、有无远处转移之间差异有统计学意义(P<0.05),与其他病理因素无关(P>0.05);前列腺癌患者肿瘤组织中的miRNA-15a 的表达与PSA 表达水平、Gleason 评分、临床分期、有无远处转移之间差异有统计学意义(P <0.05),与其他病理因素无关(P >0.05)。结论:miRNA-15a 低表达参与了前列腺癌的发生、发展过程,是前列腺癌辅助诊断及治疗的潜在的指标。     

The significance of PSA/IGF-1 ratio in differentiating benign prostate hyperplasia from prostate cancer

The importance of insulin-like growth factor 1 (IGF-1) in human serum for the early diagnosis of prostate cancer is controversial. The IGF-1/PSA ratio may improve the performance of prostate specific antigen (PSA) as a prostate cancer marker. IGF-1, along with PSA and free PSA concentration, was measured in the serum of 34 patients with prostate cancer and in 131 patients with benign prostatic hyperplasia (BPH). Although IGF-1 concentration did not significantly differ between the groups, PSA/IGF-1 ratio could clearly distinguish the two groups. In patients with cancer but not in patients with BPH, IGF-1 concentration correlated with PSA and free PSA. The values of PSA and free PSA correlated with each other for both groups. Receivers Operating Curve (ROC) analysis indicated a better sensitivity to specificity ratio for PSA/IGF-1 than for PSA or Free/Total (F/T) PSA.     

Analysis of NKX3.1 expression in prostate cancer tissues and correlation with clinicopathologic features

This study aimed to analyze NKX3.1 expression in tissue samples of benign prostate hyperplasia (BPH) and in three different prostate cancer categories. The correlation of NKX3.1 expression with clinical and pathologic features of patients having undergone radical prostatectomy also was investigated. NKX3.1 expression was determined in tissue samples obtained from four different histopathological categories: (1) from patients treated with transurethral prostatectomy for BPH (n = 26), (2) localized prostate cancer patients subjected to radical prostatectomy (n = 38), (3) biopsy samples from prostate cancer patients who were metastatic at the initial admission (n = 10), and (4) tissue samples of prostate cancer patients administered antiandrogens, but who had undergone transurethral prostatectomy for infravesical obstruction (n = 11). Standard immunohistochemical staining was performed using an antiserum raised against recombinant human NKX3.1. Staining was seen in all categories of prostatic tissues. Immunohistochemistry staining scores were lower in prostate cancer patients. The staining scores were significantly higher in patients with BPH compared to metastatic or localized prostate cancer patients. Staining scores of patients with BPH and of those under antiandrogen therapy were similar. No significant correlation was found between NKX3.1 expression and tumor volume, Gleason sum scores, the presence of extraprostatic extension, tumor stage, or serum PSA. NKX3.1 expression is significantly decreased in prostate cancer patients when compared to BPH. However, the decline of NKX3.1 expression was not correlated with prostate cancer progression and was not associated with advanced stage. Thus, NKX3.1 expression is not a clinically valuable prognostic factor.     

血清PSA和BALP测定在前列腺癌骨显像诊断中的应用

目的：探讨血PSA和BALP的测定在前列腺癌骨显像诊断中的应用。方法：对96例前列腺癌患者的核素骨显像结果、血清PSA和BALP结果进行回顾性研究。结果：①血清PSA和BALP的值随着骨转移分期的增高而逐步升高,且差异显著（P〈0.01）;②血清PSA和BALP与骨转移的数目呈正相关,相关系数（r）分别为0.582（P〈0.01）和0.768（P〈0.01）;③血清PSA〉20ng/ml时,骨转移的阳性率为65.4%,血清PSA〈20ng/ml时,骨转移的阴性预测值为92.6%;血清BALP〉20u/L时,骨转移的阳性率为58.9%时,骨转移的阴性预测值为76.5%;当血清PSA〈20ng/ml同时BALP〈20u/L时,骨转移的阴性预测值为100%。结论：血清PSA和BALP测定在前列腺癌骨显像诊断中具有重要的应用价值。     

Apoptosis incidence and protein expression of p53, TGF-beta receptor II, p27Kip1, and Smad4 in benign, premalignant, and malignant human prostate

Deregulation of apoptosis is involved in prostate cancer development and progression. This study involved an immunohistochemical "profiling" of prostate tissue specimens from patients who underwent prostatectomy for localized prostate cancer, to identify apoptosis-specific alterations associated with premalignant precursor lesions. Prostate tissue was pathologically evaluated, and areas of benign acini, high-grade prostate intraepithelial neoplasia (HGPIN), and prostate cancer were identified. Immunohistochemical analysis was performed to determine the expression of p27Kip1, a key cell cycle regulator, transforming growth factor (TGF)-beta receptor II (TbetaRII), a critical signaling effector of TGF-beta; Smad4, a downstream intracellular effector of TGF-beta signaling; p53, a key apoptosis regulator; and prostate-specific antigen (PSA), a clinical marker of prostate cancer. The apoptotic index of the same cell populations was determined using the transferase-mediated digoxigenin-tagged 16-desoxy-uridine-triphosphate nick end labeling assay. Our findings indicate a significant reduction in p27Kip1 immunoreactivity in HGPIN (P<0.0001) and prostate cancer (P<0.0001) compared with the benign tissue. A significant down-regulation was detected in TbetaRII expression in HGPIN and prostate cancer compared with benign prostatic hyperplasia (BPH)(P<0.001). A significant decrease was also observed in Smad4 levels in HGPIN and prostate cancer compared with BPH (P<0.001). Evaluation of the incidence of apoptosis revealed a significant decrease in the apoptotic index among the epithelial cell populations in HGPIN and a further decrease in prostate carcinoma (P<0.01). This reduced apoptotic index correlated with a significant increase in p53 immunoreactivity in the prostatic carcinoma foci. Prostate cancer cells exhibited strong nuclear staining for p53 compared with adjacent HGPIN (P<0.05) and the benign lesions of the same prostate specimens (P<0.05). A significant reduction in PSA immunostaining was detected in HGPIN and prostate carcinoma foci compared with the benign glandular epithelia (P<0.001). These results further define deregulation of TGF-beta signaling effectors as a molecular basis for loss of apoptotic control contributing to the development of prostate tumors. Identification of apoptotic regulators in precursor premalignant lesions may have prognostic significance in disease progression as well as therapeutic value for targeting prostate cancer.     

前列腺增生症患者血清前列腺特异性抗原水平与前列腺炎关系的临床研究

目的探讨前列腺增生症患者血清中前列腺特异性抗原水平与前列腺炎的关系。方法120例门诊诊断为前列腺增生症的患者,其血清前列腺特异性抗原高于4.0ng/ml且合并前列腺炎;所有患者口服莫西沙星,治疗随访4周;根据治疗后血清前列腺特异性抗原水平及前列腺穿刺活检结果分为三组,观察比较各组治疗前后血清前列腺特异性抗原的水平及前列腺癌诊断阳性率。结果仅治疗后血清前列腺特异性抗原低于4.0ng/ml的一组在治疗前后的水平变化有统计学意义,其余两组均无统计学意义;治疗后前列腺癌诊断阳性率明显高于治疗前。结论对血清前列腺特异性抗原高于4.0ng/ml且合并前列腺炎的前列腺增生患者进行抗炎治疗,既可提高前列腺特异性抗原对前列癌早期诊断的特异性,又可使部分患者避免前列腺穿刺活检造成的痛苦和相关并发症。     

Differential expression of MSX2 in nodular hyperplasia, high-grade prostatic intraepithelial neoplasia and prostate adenocarcinoma

One of the common features in advanced prostate cancer is bone metastasis. In this study, we investigated the clinical relevance of a bone factor, MSX2, in predicting the metastatic ability of prostate adenocarcinoma. Evaluation of MSX2 expression was performed using prostate cell lines as well as patient specimens. A sharp decrease in MSX2 was found in primary prostate cancer cells, 22Rv1, when compared with the non-malignant counterparts, followed by a gradual increase in more aggressive prostate cancer cell lines. Interestingly, the MSX2 protein was upregulated and predominantly expressed in the nucleus in aggressive prostate cancer cell line, C4-2b, compared with the less aggressive 22Rv1. Consistent with the in vitro results, MSX2 nuclear expression was significantly higher in nodular hyperplasia when compared with high-grade prostatic intraepithelial neoplasia (PIN), while MSX2 nuclear expression in prostate adenocarcinoma was higher than that in high-grade PIN. Importantly, MSX2 expression was increased significantly in tumors with metastasis compared with those without metastasis. Finally, MSX2 nuclear scores were significantly increased in patients with preoperative serum PSA >20 ng/mL. No correlation between MSX2 nuclear score and Gleason score was found. Taken together, MSX2 may serve as a potential biomarker in predicting primary prostate tumors with higher metastatic capability.