【摘要】 目的应用巢氏逆转录聚合酶链反应(RT-PCR)检测前列腺癌(PCa)患者外周血前列腺特异性膜抗原mRNA(PSMA mRNA)的表达并探讨其临床应用意义。方法采用巢氏RT-PCR检测28例PCa患者、20例前列腺增生(BPH)患者和10例健康男性外周血中PSMA mRNA的表达情况。结果28例PCa患者中PSMA mRNA表达阳性18例,20例BPH患者和10例健康男性均为阴性,检测灵敏度为64.29%,特异性为100.00%。18例接受内分泌治疗的患者中PSMA mRNA表达阳性13例,阳性率为72.22%,未接受内分泌治疗的患者阳性率为40.00%。PSMA mRNA与前列腺特异性抗原(PSA)水平具有明显相关性,随着PSA水平的升高PSMA mRNA阳性率也随之升高,各组间比较差异有统计学意义(P<0.05)。PSMA mRNA与PCa的临床分期也有明显的相关性,D期PCa患者的PSMA mRNA阳性率明显高于B、C期,差异有统计学意义(P<0.05)。PSMA mRNA与PCa的病理分期无明显相关性。PSMA mRNA与PCa的转移有明显的相关性,己出现骨转移者PSMA mRNA阳性率明显升高,差异有统计学意义(P<0.05)。结论巢氏RT-PCR检测PCa患者外周血中PSMA mRNA表达的方法是一种十分有应用价值的诊断PCa及监测PCa微转移的方法,特别是对接受过内分泌治疗的患者,检测PSMA mRNA要比PSA mRNA更有意义。更多还原

【Abstract】 Objective To explore the clinical significance of nested reverse transcriptase polymerase chain reaction (RT-PCR) assay for peripheral blood prostate specific membrane antigen (PSMA) mRNA expression in patients with prostatic carcinoma (PCa).Methods Nested reverse transcriptase polymerase chain reaction (RT-PCR) assay was applied to detecting peripheral blood PSMA mRNA for 28 patients with PCa,20 patients with benign prostatic hyperplasia (BPH) and 10 healthy adult males.Results (1)PSMA mRNA was detected in 18 blood samples from the 28 patients with PCa, but no positive results were found in BPH group and healthy control group;with 64.29% of sensitivity and 100.00% of specificity.(2)PSMA mRNA was detected in 13 blood samples (72.22%) from the 18 patients with hormonal therapy,while the positive rate of patients without hormonal therapy was 40.00%.(3)PSMA mRNA was closely correlative to prostate specific antigen (PSA),which positive rate increased along with the elevation of PSA level.PSMA mRNA was also associated with the clinical stage of PCa;the PSMA mRNA positive rate of patients in phase D significantly higher than that of ones in phase B or C(P<0.05).(4)PSMA mRNA wasn’t relative to the pathological stage of PCa,but closely relative to PCa metastasis.The PSMA mRNA positive rate was markedly elevated in patients complicated with osseous metastasis.Conclusion Nested RT-PCR assay for PSMA mRNA in peripheral blood is a very important measurement to diagnose prostatic carcinoma and monitor the micrometastasis of PCa.Especially for patients undergoing hormonal therapy,PSMA mRNA is superior to PSA.更多还原