血清胸苷激酶的检测以及其在前列腺癌早期筛查中的意义

目的前列腺癌是一种老年男性泌尿生殖系统常见的恶性肿瘤，近年其发病率呈上升趋势，已高居泌尿生殖系统肿瘤的前3位，且发病年龄也日趋年轻化。长期以来，人们对前列腺癌的检测手段一直停留在直肠指诊、PSA筛查和穿刺活检上。能否早期诊断、早期治疗前列腺癌在临床上就显得尤为重要。本研究旨在探讨通过检测血清胸苷激酶1（TK）在早期诊断前列腺癌中的可行性和有效性。方法采用免疫印迹-增强化学发光检测法，检测在本院就诊的150例男性患者血清胸苷激酶1水平，其中70例为前列腺癌患者（年龄29～80岁），40例为前列腺增生患者（年龄50～92岁），另40例为来本院作健康体检的健康男性（年龄35～50岁）。结果1）前列腺癌组：70例经过病理活检确诊的前列腺癌患者，STK1值（3．66±1．91）pM／L，灵敏度71．5％。2）前列腺增生组：40例同期治疗的病理检查确诊的前列腺增生患者（1．28±0．35）pM／L，特异度85％。3）健康对照组：40例健康人检查结果均无泌尿系统疾病，STK1值（0．79±0．27）pM／L，无一例异常结果。经血清胸苷激酶1检测发现，前列腺癌组与健康男性组间TK1水平差异有统计学意义（P〈0．05）。前列腺癌组与前列腺增生组血清胸苷激酶1水平差异有统计学意义（P〈0．05）。血清胸苷激酶1对前列腺肿瘤TMN分期，T135例，T219例，L10例，T46例的灵敏度分别为：62．85％（22／35）、73．68％（14／19）、80．00％（8／10）、100．00％（6／6）。结论使用血清胸苷激酶检测前列腺癌中有显著的特异性，可作为前列腺癌的早期筛查方法。

The measurement of serum thymidine kinase and its clinical significance in early screening of prostatic carcinoma

Objective To evaluate the possibility and validity of serum thymidine kinase measurement in early screening of prostatic carcinoma.Methods Serum level of thymidine kinase was measured by applying Western blot-enhanced chemiluminecence assay in 150 males,including 70 cases of prostatic carcinoma(prostatic carcinoma group,aged 29-80),40 cases of hyperplasia of prostate gland(hyperplasia group,aged 50-92)and 40 cases of healthy controls(healthy control group,aged 35-50).Results The serum level of thymidine kinase(STK1)and sensitivity was(3.66±1.91)pM/L and 71.5%(50/70)in prostatic carcinoma group;STK1 and specificity was(1.28±0.35)pM/L and 85%(34/40)in hyperplasia group;STK1 was(0.79±0.27)pM/L and no abnormal result was found in healthy control group.There was statistical difference of STK l level between prostatic carcinoma group and healthy control group(P<0.05)and between prostatic carcinoma group and hyperploasia group(P<0.01).The sensitivity of STKl to TNM stage(T_1,T_2,T_3 and T_4)was 62.85% (22/35),73.68%(14/19),80.00%(8/10)and 100.00%(6/6)respectively.Conclusion Serum thymidine kinase measurement is of high specificity,which can be used as a method of early screening of prostatic carcinoma.