【摘要】 目的 :采用巢式RT -PCR方法 ,检测前列腺癌合并骨转移的患者外周血中前列腺特异抗原 (PSA)、前列腺特异膜抗原 (PSMA)和人腺体激肽释放酶mRNA的表达 ,探讨其临床意义。方法 :应用巢式RT -PCR的方法 ,检测外周血中PSA、PSMA和hK2mRNA表达。结果 :巢式PCR能够检测到经淋巴细胞稀释的LNCaP细胞的PSA、PSM和hK2mRNA的灵敏度 ,稀释浓度分别为 1 0 -6、1 0 -6及 1 0 -7。检测初发伴骨转移的前列腺癌患者外周血PSA、PSMA和hK2mRNA的阳性率分别为 5 9.4 5 %、5 1 .35 %、5 9.4 6 % ,其中三种检测同时阳性的为 32 .4 3% ;检测接受内分泌治疗后出现骨转移的前列腺癌患者的阳性率分别为 5 7.1 4 %、85 .71 %、83.33% ,其中三种检测同时阳性的为 5 2 .4 8%。局限性前列腺癌患者、健康男性及健康女性的检测结果均为阴性。以 β actinmRNA做为内参照 ,所有临床标本检测均为阳性。结论 :采用巢式RT PCR检测前列腺癌患者外周血PSMA、hK2和PSAmRNA有助于发现进入循环系统的前列腺癌细胞 ,提示隐匿性转移的存在。PSMA和hK2较适合用于内分泌治疗后患者的检测。三种指标联合检测有助于提高敏感性更多还原

【Abstract】 Objective: To study the prostate specific antigen (PSA), prostate specific membrane antigen (PSMA) and human glandular kallikrein (hK2) mRNA in peripheral blood samples of prostate cancer (PC) patients with bone metastasis by nested reverse transcriptase polymerase chain reaction (RT-PCR) based assay, and to discuss their clinical implications. Methods: Samples of peripheral blood were analyzed by nested RT PCR to identify PSA, PSMA and hK2 mRNA expression. Results: RT-PCR assay was applied to identify the PSA, PSMA and hK2 mRNA expressing LNCaP cells, which were diluted by lymphocytes to 10 -6 , 10 -6 and 10 -7 separately. Positive rates of the three markers in newly diagnosed PC patients with bone metastasis were 59.45%, 51.35% and 59.46% respectively, and 32.43% cases showed three positives. In PC patients who had developed bone metastasis after endocrine therapy, the positive rates were 57.14%, 85.71% and 83.33% respectively, and 52.48% cases showed three positives. All samples were negative in regional PC patients and healthy individuals, and all samples were positive for β actin mRNA, the internal control. Conclusion: Nested RT-PCR based assay for PSA, PSMA or hK2 mRNA helps to detect prostate cancer cells in the circulation system, thus providing evidence for occult metastasis. PSMA and hK2 were advisable markers to monitor disease progression after androgen blockage. Combined assays of PSMA and hK2 are suitable for patients who underwent endocrine therapy, and combined assays of the three markers have enhanced sensitivity.更多还原