精子相关抗原9联合PSAD、fPSA/tPSA比值诊断PSA灰区前列腺癌的临床研究

doi:10.3969/j.issn.1004-616x.2024.02.008

癌变·畸变·突变 ›› 2024, Vol. 36 ›› Issue (2): 129-132,163.doi: 10.3969/j.issn.1004-616x.2024.02.008

• 论著 • 上一篇

精子相关抗原9联合PSAD、fPSA/tPSA比值诊断PSA灰区前列腺癌的临床研究

沈红梅, 刘培龙, 顾屏, 贲亮亮, 徐珍玉

南通市第二人民医院/南通大学附属康复医院检验科, 江苏南通 226002

收稿日期:2023-08-14 修回日期:2024-01-05 发布日期:2024-04-11
通讯作者: 刘培龙
作者简介:沈红梅,E-mail:13382340372@163.com
基金资助:
国家重点研发计划项目(2021YFC2009300)

Diagnostic value of sperm-associated antigen 9 combined with PSAD and fPSA/tPSA ratio for prostate cancer in the PSA grey zone

SHEN Hongmei, LIU Peilong, GU Ping, BEN Liangliang, XU Zhenyu

Department of Laboratory, the Second People's Hospital of Nantong/ Affiliated Rehabilitation Hospital of Nantong University, Nantong 226002, Jiangsu, China

Received:2023-08-14 Revised:2024-01-05 Published:2024-04-11

摘要/Abstract

摘要： 目的：研究尿液中精子相关抗原9(SPAG9)含量联合血清中前列腺特异性抗原密度(PSAD)、游离前列腺特异性抗原(fPSA)/总PSA(tPSA)比值诊断PSA灰区前列腺癌的价值。方法：选择2018年1月—2022年12月期间在南通市第二人民医院门诊或住院收治的血清PSA水平处于灰区(4~10 ng/mL)的309例患者作为研究对象，根据前列腺穿刺术的病理结果分为前列腺癌组58例和前列腺良性组 251例(对照组)。所有患者均在术前留取尿液并检测 SPAG9含量，测定血清 PSAD、fPSA、tPSA，计算 fPSA/tPSA比值，比较两组间临床资料的差异，采用 Logistic回归分析确定前列腺癌的相关因素，绘制受试者工作特征(ROC)曲线、计算曲线下面积(AUC)并分析各指标对前列腺癌的诊断价值。结果：前列腺癌组和对照组间患者的体质量、tPSA、白细胞计数、血红蛋白、血小板计数、总胆红素、白蛋白、肌酐、尿酸、前列腺体积的差异均无统计学意义(P>0.05)；前列腺癌组患者的年龄、尿液SPAG9含量、血清 fPSA/tPSA比值、PSAD均高于对照组，差异均有统计学意义(P<0.05)；多因素 Logistic回归分析显示，尿液 SPAG9含量、血清fPSA/tPSA比值、PSAD是前列腺癌的影响因素；ROC曲线分析显示，尿液SPAG9含量、血清fPSA/tPSA比值、PSAD单独及联合均能诊断前列腺癌，3项指标联合的诊断效能理想，灵敏度和特异度分别为 80.00%和 80.88%。结论：尿液 SPAG9可作为诊断PSA灰区前列腺癌的标志物，尿液SPAG9与血清fPSA/tPSA比值、PSAD联合检测对PSA灰区前列腺癌具有较好的诊断效能。

关键词: 前列腺癌, PSA灰区, 精子相关抗原9, 前列腺特异性抗原密度, 游离PSA/总PSA比值

Abstract: OBJECTIVE：To study the diagnostic value of sperm-associated antigen 9 (SPAG9) in urine combined with prostate-specific antigen density (PSAD)，free prostate-specific antigen (fPSA)/total PSA (tPSA) ratio in blood for the diagnosis of prostate cancer in the PSA grey zone. METHODS：From January 2018 to December 2022， 309 patients with serum PSA in the gray zone (4-10 ng/mL) who were admitted to the Second People's Hospital of Nantong were selected as the study subjects. They were divided into case and control groups： 58 prostate cancer case group and 251 benign cancer control group according to the pathological results of prostatocentesis. Before surgery， urine and blood samples from patients were collected and SPAG9，PSAD and fPSA/tPSA were determined. Differences in clinical data between the two groups were identified， and the related factors of prostate cancer were analyzed by logistic regression. The receiver operating characteristic curve (ROC) was drawn， and the area under the curve (AUC) was calculated. The diagnostic value of each indicator for prostate cancer in PSA gray zone was analyzed. RESULTS：Among the two groups of patients，there were no significant differences in body weight，tPSA，white blood cell count， hemoglobin，platelet count，total bilirubin，albumin，creatinine，uric acid and prostate volume between them (P>0.05). However，the age，urinary SPAG9，fPSA/tPSA and PSAD of the case group were significantly higher than those of the control group (P<0.05). Multivariate logistic regression analysis showed that SPAG9， fPSA/ tPSA and PSAD were related factors for prostate cancer. ROC curve analysis showed that SPAG9，fPSA/tPSA and PSAD alone and in combination could diagnose prostate cancer. The combined efficacy of the 3 indexes was ideal，and the sensitivity and specificity were 80.00% and 80.88% respectively. CONCLUSION：Urine SPAG9 can be used as a marker for the diagnosis of prostate cancer in PSA grey zone，and the combination of SPAG9，serum fPSA/tPSA and PSAD can provide good diagnostic efficacy.

Key words: prostate cancer, PSA gray area, sperm-associated antigen 9, prostate-specific antigen density, free PSA/total PSA ratio

中图分类号:

R730.4

沈红梅, 刘培龙, 顾屏, 贲亮亮, 徐珍玉. 精子相关抗原9联合PSAD、fPSA/tPSA比值诊断PSA灰区前列腺癌的临床研究[J]. 癌变·畸变·突变, 2024, 36(2): 129-132,163.

SHEN Hongmei, LIU Peilong, GU Ping, BEN Liangliang, XU Zhenyu. Diagnostic value of sperm-associated antigen 9 combined with PSAD and fPSA/tPSA ratio for prostate cancer in the PSA grey zone[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2024, 36(2): 129-132,163.

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精子相关抗原9联合PSAD、fPSA/tPSA比值诊断PSA灰区前列腺癌的临床研究

Diagnostic value of sperm-associated antigen 9 combined with PSAD and fPSA/tPSA ratio for prostate cancer in the PSA grey zone

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