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目的探讨DD3和PSA基因在前列腺癌组织中定量表达及其临床意义。方法用实时荧光定量RT-PCR方法对21例前列腺癌组织(PCa)、39例良性前列腺增生(BPH)组织中DD3mRNA和PSAmRNA含量进行检测,用ROC曲线对DD3mRNA、PSAmRNA和DD3mRNA/PSAmRNA等指标对前列腺癌诊断价值进行评价。结果LNCaP细胞株中PSAmRNA含量约为DD3mRNA的4000倍。PCa组织中DD3mRNA和PSAmRNA含量以及DD3mRNA/PSAmRNA比值均显著高于BPH组织,差异具有统计学意义(P<0·01),但PCa不同临床分期和分化程度间差异无统计学意义(P值均>0·05)。ROC曲线分析结果显示,DD3mRNA、PSAmRNA和DD3mRNA/PSAmRNA的曲线下面积(AUC-ROC)分别为0·937(95%CI:0·879~0·995)、0·755(95%CI:0·629~0·880)和0·839(95%CI:0·738~0·940)。当DD3mRNA、PSAmRNA和DD3mRNA/PSAmRNA临界值分别为1·4×105copies/mgtissue、3·0×107copies/mgtissue和5·0×10-3时,灵敏度分别为90·5%、81·0%和81·0%;特异度分别为85·0%、62·0%和66·7%。若将DD3mRNA和PSAmRNA联合用于PCa的诊断,其特异性与DD3mRNA相同,特异性均为85·0%,灵敏度可达100%。结论PCa组织DD3mRNA、PSAmRNA和DD3mRNA/PSAmRNA较BPH组织显著增高,DD3mRNA用于PCa的诊断性能均优于PSAmRNA和DD3mRNA/PSAmRNA,DD3mRNA和PSAmRNA的联合检测时特异度与DD3mRNA相同,但可明显提高灵敏度,对PCa的早期诊断具有重要意义。
Objective To investigate the quantitative expression of DD3 and PSA in prostate cancer and its clinical significance. Methods The levels of DD3mRNA and PSAmRNA in 21 cases of PCa and 39 cases of benign prostatic hyperplasia (BPH) were detected by real-time fluorescence quantitative RT-PCR. The ROC curves were used to detect the DD3mRNA, PSAmRNA and DD3mRNA / PSAmRNA Prostate cancer diagnostic value evaluation. Results The PSA mRNA in LNCaP cell line was about 4000 times that of DD3 mRNA. PCa tissue DD3mRNA and PSAmRNA and DD3mRNA / PSAmRNA ratio were significantly higher than BPH tissue, the difference was statistically significant (P <0.01), but PCa different clinical stages and differentiation between the degree of difference was not statistically significant (P value > 0 · 05). The ROC curve analysis showed that the area under the curve (AUC-ROC) of DD3mRNA, PSAmRNA and DD3mRNA / PSAmRNA were0.937 (95% CI: 0.879-0.995), 0.755 · 629 ~ 0 · 880) and 0 · 839 (95% CI: 0 · 738 ~ 0 · 940). When the cut-off values of DD3mRNA, PSAmRNA and DD3mRNA / PSAmRNA were 1.4 × 105copies / mgtissue, 3.0 × 107copies / mgtissue and 5.0 × 10-3 respectively, the sensitivities were 90.5%, 81.0% and 81.0%; and the specificity was 85.0%, 62.0% and 66.7% respectively. If DD3mRNA and PSAmRNA were used in the diagnosis of PCa, the specificity of DD3mRNA and DD3mRNA were 85.0% and the sensitivity was up to 100%. Conclusions The diagnostic value of DD3 mRNA for PCa is higher than that of PSAmRNA and DD3mRNA / PSAmRNA in PCa tissues. The combined detection of DD3mRNA and PSAmRNA is the same as that of DD3mRNA, but the sensitivity of DD3mRNA can be significantly improved , The early diagnosis of PCa is of great significance.