Serafin Antonio M, Chinhengo Angela, Fernandez Pedro, Akudugu John M
Department of Medical Imaging and Clinical Oncology, University of Stellenbosch, Cape Town, South Africa.
Discov Med. 2018 May;25(139):235-242.
No unambiguous role of the involvement of uroplasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) in prostate cancer has emerged, with current evidence suggesting that neither biomarker is likely of significant clinical value, save as an overall contributor. In this study, we attempt to discriminate prostate cancer from non-cancer in a cohort of plasma samples, using the Imubind ELISA assay. In this cohort, PAI-1 levels are higher in prostate cancer patients than healthy donors; uPA levels are higher in healthy donors than prostate cancer patients; and the uPA/PAI-1 ratio is higher in healthy donors than in prostate cancer patients. To date, and across three prostate sample types, i.e. transurethral resection tissue, needle biopsies, and blood plasma, data have been disparate. Given the inconsistency, a malignancy index was created by dividing the product of three biomarkers [uPA, PAI-1, and prostate specific antigen (PSA)] by the age of the patient/donor. The malignancy index clearly distinguishes prostate disease from non-disease in peripheral blood plasma samples (P=0.0127), concurring with findings in core needle biopsies and transurethral resection tissue, reported elsewhere. This is an important finding given the gravity of prostate cancer and the legions of over-diagnosed and over-treated men worldwide.
尿激酶型纤溶酶原激活剂（uPA）和1型纤溶酶原激活剂抑制剂（PAI-1）在前列腺癌中的作用尚无明确结论，目前证据表明这两种生物标志物不太可能具有显著临床价值，仅作为总体因素存在。在本研究中，我们尝试使用Imubind ELISA检测法在一组血浆样本中鉴别前列腺癌与非癌情况。在该队列中，前列腺癌患者的PAI-1水平高于健康供体；健康供体的uPA水平高于前列腺癌患者；且健康供体的uPA/PAI-1比值高于前列腺癌患者。迄今为止，在三种前列腺样本类型，即经尿道切除组织、穿刺活检组织和血浆中，数据存在差异。鉴于这种不一致性，通过将三种生物标志物[uPA、PAI-1和前列腺特异性抗原（PSA）]的乘积除以患者/供体的年龄来创建恶性指数。该恶性指数在周围血浆样本中能清晰地区分前列腺疾病与非疾病状态（P=0.0127），这与其他地方报道的在穿刺活检组织和经尿道切除组织中的研究结果一致。鉴于前列腺癌的严重性以及全球大量被过度诊断和过度治疗的男性患者，这是一项重要发现。
