Wei Wei, Leng Jiangyong, Shao Hongxiang, Wang Weidong
Department of Urinary Surgery, Ningbo No. 2 Hospital No. 41 Xibei Street, Ningbo 315000, Zhejiang Province, China.
Int J Clin Exp Med. 2015 Sep 15;8(9):16606-12. eCollection 2015.
To improve the prediction of prostate cancer (PCA) risk and pathological type of PCA by non-invasive approaches before performing prostatic biopsy are the current challenges for the management of PCA. The aim of this present study was evaluate the clinical validity of prostate cancer associated 3 (PCA3) gene in the prediction of PCA and the correlations between the PCA3 level and prognostic factors.
A total of 207 patients with suspected prostate cancer in Ningbo No. 2 hospital between June 2012 and July 2014 were enrolled in this study. All patients included underwent prostate biopsy under the direction of digital rectal examination (DRE) and were divided into PCA group and no evidence of malignancy (NEM) group according to the pathological diagnosis. We analyzed the association between PCA3 score and indicators of prognosis (Gleason score, percentage of positive cores and clinical stage) by multivariate analysis.
The levels of total prostate-specific antigen (t-PSA), prostate health index (PHI) and PCA3 score in patients with PCA were significantly higher than those in NEM group (P<0.05). In PCA group, PHI value and t-PSA were both factors significantly correlated with high Gleason score and clinical stage (P<0.05). A high PCA3 score in urine was significantly correlated with a high Gleason score, % positive cores and an advanced clinical stage (P<0.05).
PCA3 score might be one of useful diagnostic tools for determining suitable therapeutic programs for PCa and predicting the prognosis.
在进行前列腺活检之前，通过非侵入性方法改善前列腺癌（PCA）风险预测和PCA病理类型是当前PCA管理面临的挑战。本研究的目的是评估前列腺癌相关3（PCA3）基因在预测PCA方面的临床有效性以及PCA3水平与预后因素之间的相关性。
2012年6月至2014年7月期间，宁波第二医院共纳入207例疑似前列腺癌患者。所有纳入患者均在直肠指检（DRE）引导下进行前列腺活检，并根据病理诊断分为PCA组和无恶性证据（NEM）组。我们通过多因素分析分析了PCA3评分与预后指标（Gleason评分、阳性核心百分比和临床分期）之间的关联。
PCA患者的总前列腺特异性抗原（t-PSA）、前列腺健康指数（PHI）和PCA3评分水平显著高于NEM组（P<0.05）。在PCA组中，PHI值和t-PSA均是与高Gleason评分和临床分期显著相关的因素（P<0.05）。尿液中PCA3高评分与高Gleason评分、阳性核心百分比和晚期临床分期显著相关（P<0.05）。
PCA3评分可能是确定PCa合适治疗方案和预测预后的有用诊断工具之一。
