Department of Urology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Biomedical Research Institute, Kyungpook National University, Daegu, Republic of Korea.
PLoS One. 2021 Apr 26;16(4):e0250254. doi: 10.1371/journal.pone.0250254. eCollection 2021.
This prospective study sought to clarify the developmental endothelial locus-1 (Del-1) protein as values of diagnosis and risk stratification of prostate cancer (PCa).
From February 2017 to December 2019, a total 458 patients who underwent transrectal ultrasound guided prostate biopsy or surgery of benign prostatic hyperplasia agreed to research of Del-1 protein. We prospectively compared and analyzed the Del-1 protein and prostate specific antigen (PSA) in relation to the patients' demographic and clinicopathological characteristics.
Mean age was 68.86±8.55 years. Mean PSA and Del-1 protein was 21.72±89.37, 0.099±0.145, respectively. Two hundred seventy-six (60.3%) patients were diagnosed as PCa. Among them, 181 patients underwent radical prostatectomy (RP). There were significant differences in Del-1 protein between benign and PCa group (0.066±0.131 vs 0.121±0.149, respectively, p<0.001). When we set the cut-off value of del-1 protein as 0.120, in patients with 3≤PSA≤8, positive predictive value and specificity of Del-1 protein (≥0.120) for predicting PCa were 88.9% (56/63) and 93.5% (101/108), respectively. Among 181 patients who underwent RP, there were significant differences in Del-1 protein according to stage (pT2 vs pT3a vs ≥pT3b) (0.113±0.078, 0.171±0.121, 0.227±0.161, respectively, p<0.001) and to Gleason score (6 (3+3) or 7 (3+4) vs 7 (4+3) or 8 (4+4) vs 9 or 10) (0.134±0.103, 0.150±0.109, 0.212±0.178, respectively, P = 0.044). Multivariate analysis showed that PSA, Del-1 protein and high Gleason score (≥9) were the independent prognostic factors for predicting higher pT stage (≥3b). Furthermore, age, PSA and Del-1 protein were independent prognostic factors for predicting significant PCa.
Patients with PCa showed higher expression of Del-1 protein than benign patients. Del-1 protein increased with the stage and Gleason score of PCa. Collaboration with PSA, Del-1 protein can be a non-invasive useful marker for diagnosis and risk stratification of PCa.
本前瞻性研究旨在阐明发育内皮基因座 1（Del-1）蛋白作为前列腺癌（PCa）诊断和风险分层的价值。
从 2017 年 2 月至 2019 年 12 月，共有 458 名接受经直肠超声引导前列腺活检或良性前列腺增生手术的患者同意进行 Del-1 蛋白研究。我们前瞻性比较和分析了 Del-1 蛋白和前列腺特异性抗原（PSA）与患者的人口统计学和临床病理特征的关系。
平均年龄为 68.86±8.55 岁。平均 PSA 和 Del-1 蛋白分别为 21.72±89.37、0.099±0.145。276 名（60.3%）患者被诊断为 PCa。其中 181 名患者接受了根治性前列腺切除术（RP）。良性和 PCa 组之间的 Del-1 蛋白有显著差异（分别为 0.066±0.131 和 0.121±0.149，p<0.001）。当我们将 del-1 蛋白的截断值设定为 0.120 时，在 PSA 为 3≤PSA≤8 的患者中，Del-1 蛋白（≥0.120）预测 PCa 的阳性预测值和特异性分别为 88.9%（56/63）和 93.5%（101/108）。在接受 RP 的 181 名患者中，Del-1 蛋白根据分期（pT2 与 pT3a 与≥pT3b）（0.113±0.078、0.171±0.121、0.227±0.161，分别，p<0.001）和 Gleason 评分（6（3+3）或 7（3+4）与 7（4+3）或 8（4+4）与 9 或 10）（0.134±0.103、0.150±0.109、0.212±0.178，分别，P=0.044）存在显著差异。多变量分析表明，PSA、Del-1 蛋白和高 Gleason 评分（≥9）是预测更高 pT 期（≥3b）的独立预后因素。此外，年龄、PSA 和 Del-1 蛋白是预测显著 PCa 的独立预后因素。
PCa 患者的 Del-1 蛋白表达高于良性患者。Del-1 蛋白随着 PCa 的分期和 Gleason 评分的增加而增加。与 PSA 联合，Del-1 蛋白可作为诊断和 PCa 风险分层的一种非侵入性有用标志物。
