Pipinikas Christodoulos P, Nair Sabarinath B, Kirby Roger S, Carter Nicholas D, Fenske Christiane D
St George's University of London, Clinical Developmental Sciences, Medical Genetics, London, UK.
Biomarkers. 2007 Sep-Oct;12(5):541-57. doi: 10.1080/13547500701391353.
The use of serum prostate-specific antigen (PSA) measurements necessitates biopsies for accurate prostate cancer (CaP) diagnosis. Overall efficiency of accurate diagnosis, when PSA levels are used alone, is less than 60%. E2F3 was evaluated as an alternative biomarker using patient blood samples. Expression levels were measured by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and correlated with accurate clinicopathological data. Statistical analysis demonstrated significant differences in E2F3 expression levels (p<0.0001), and high levels of discrimination (receiver operator curve/area under curve analysis values (AUC) >0.88), in particular at early stages of disease development, between benign disease and localized CaP. Limited levels of discrimination were observed at the later stages of disease development, between localized and metastatic disease (p=0.076, AUC=0.633). A cut-off point of 0.34 with high specificity for benign disease (92.3%) and sensitivity for CaP diagnosis (81.0%) was identified. At this cut-off point, 85% patients were correctly diagnosed with either malignant or benign disease. This study demonstrates the strength of E2F3 as a potential marker for discriminating benign and malignant disease, addressing the current limitations of serum PSA measurements.
使用血清前列腺特异性抗原（PSA）检测需要进行活检以准确诊断前列腺癌（CaP）。单独使用PSA水平时，准确诊断的总体效率低于60%。使用患者血液样本评估E2F3作为替代生物标志物。通过定量逆转录聚合酶链反应（qRT-PCR）测量表达水平，并与准确的临床病理数据相关联。统计分析表明，E2F3表达水平存在显著差异（p<0.0001），并且具有较高的鉴别能力（受试者操作特征曲线/曲线下面积分析值（AUC）>0.88），特别是在疾病发展的早期阶段，良性疾病和局限性CaP之间。在疾病发展的后期阶段，局限性疾病和转移性疾病之间的鉴别能力有限（p=0.076，AUC=0.633）。确定了一个截断点为0.34，对良性疾病具有高特异性（92.3%）和对CaP诊断具有敏感性（81.0%）。在这个截断点，85%的患者被正确诊断为恶性或良性疾病。本研究证明了E2F3作为区分良性和恶性疾病的潜在标志物的优势，解决了目前血清PSA检测的局限性。
