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目的:探讨DD3基因在前列腺组织中表达的临床意义。方法:用荧光定量RT-PCR方法对21例前列腺癌(PCa)组织、27例非前列腺部位的肿瘤组织、39例良性前列腺增生(BPH)组织和15例正常前列腺组织中的DD3的表达进行了定量分析,用ROC曲线对DD3 mRNA诊断PCa的性能进行了分析。结果:27例非前列腺组织中均未检测到DD3基因的表达。DD3在PCa组、BPH组和正常前列腺组表达量的中位数分别为7.2×106、2.5×104、1.5×104拷贝/mg组织。PCa组较BPH组和正常前列腺组DD3的表达量显著增高(P<0.01),而BPH组和正常前列腺组间则差异无显著性(P>0.05)。DD3表达量与临床分期和分化程度之间均无明显相关性。DD3 mRNA曲线下面积(AUC-ROC)为0.937(95%CI:0.879～0.995)。当临界值为1.4×105拷贝/mg组织时,灵敏度、特异度、准确度、阳性预测值(PPV)、阴性预测值(NPV)、阳性拟然比(+LR)、阴性拟然比(-LR)分别为90.5%、85.0%、86.7%、76.0%、94.3%、6.03和0.11。结论:DD3 mRNA的表达仅限于前列腺组织,具有良好的组织特异性。DD3 mRNA表达在PCa组织中显著升高,在正常前列腺和BPH组织中差异无显著性。DD3 mRNA可作为PCa诊断的良好标志物,在PCa早期诊断、微转移诊断、预后判断、指导治疗等方面也具有潜在的应用价值。
Objective: To investigate the clinical significance of DD3 gene expression in prostate tissue. Methods: The expression of DD3 in 21 cases of prostate cancer (PCa), 27 cases of non-prostate tumor tissue, 39 cases of benign prostatic hyperplasia (BPH) and 15 cases of normal prostatic tissue were detected by real-time fluorescence quantitative RT-PCR Quantitative analysis, using ROC curve DD3 mRNA diagnostic PCa performance were analyzed. Results: No DD3 gene expression was detected in 27 cases of non-prostate tissue. The median of DD3 expression in PCa group, BPH group and normal prostate group were 7.2 × 106, 2.5 × 104 and 1.5 × 104 copies / mg tissue, respectively. The expression of DD3 in PCa group was significantly higher than that in BPH group and normal prostate group (P <0.01), but there was no significant difference between BPH group and normal prostate group (P> 0.05). DD3 expression levels and clinical stage and the degree of differentiation between no significant correlation. The area under the curve of DD3 mRNA (AUC-ROC) was 0.937 (95% CI: 0.879-0.995). The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive predictive value (+ LR) and negative predictive value LR) were 90.5%, 85.0%, 86.7%, 76.0%, 94.3%, 6.03 and 0.11, respectively. Conclusion: The expression of DD3 mRNA is limited to prostate tissue and has good tissue specificity. The expression of DD3 mRNA in PCa tissue was significantly higher than that in normal prostate and BPH tissues. DD3 mRNA can be used as a good marker in the diagnosis of PCa. It also has potential application value in the early diagnosis of PCa, micrometastasis diagnosis, prognosis judgment and guiding treatment.