CAJ | 학술논문

目的:探讨局限性前列腺癌经前列腺癌氩氦冷冻治疗后血清HMGB1和PSA表达在预测治疗后复发中的临床价值.方法:应用酶联免疫吸附试验(ELISA)测定80例局限性前列腺癌患者(Pca组)冷冻治疗前、后和30例前列腺良性增生患者(BPH组)、20例健康对照者血清HMGB1和PSA表达.Pca组术后PSA、MRI随访,经病理穿刺活检证实:局部复发9例,远处转移3例.比较Pca组术后血清HMGB1表达,及预测前列腺癌复发的价值.结果:Pca组术前血清HMGB1(94.0±77.4 ng/mL)相比BPH组(33.2±7.4 ng/mL)和健康对照组(24.7±7.3 ng/mL)显著升高(P<0.001).Pca组术后血清HMGB1(55.0±11.0 ng/mL)较术前显著降低(P=0.005);Pca组冷冻治疗后,复发者术后HMGB1平均值为(70.8±2.7)ng/mL,无复发者术后HMGB1平均值为(55.0±10.8) ng/mL,差异有统计学意义(P=0.001);3例远处转移患者血清HMGB1水平较9例局部复发者显著升高(94.2±17.9 vs.73.1±7.9 ng/mL).术后血清HMGB1相比PSA预测复发性Pca的敏感性高(83.3%Vs.66.7%),而两者联合诊断的特异性较单一PSA高(95.6%vs.82.4%).Pca组术后HMGB1表达与临床分期、复发和转移(P<0.001)相关,与Gleason评分无显著相关性(P>0.05).结论:血清HMGB1在Pca中高表达,提示血清HMGB1可作为一项预测和预后指标.此外,Pca患者冷冻治疗后联合检测HMGB1和PSA对于复发患者可提高早期诊断率,有效的指导病理穿刺活检及后续治疗.
목적:탐토국한성전렬선암경전렬선암아양냉동치료후혈청HMGB1화PSA표체재예측치료후복발중적림상개치.방법:응용매련면역흡부시험(ELISA)측정80례국한성전렬선암환자(Pca조)냉동치료전、후화30례전렬선량성증생환자(BPH조)、20례건강대조자혈청HMGB1화PSA표체.Pca조술후PSA、MRI수방,경병리천자활검증실:국부복발9례,원처전이3례.비교Pca조술후혈청HMGB1표체,급예측전렬선암복발적개치.결과:Pca조술전혈청HMGB1(94.0±77.4 ng/mL)상비BPH조(33.2±7.4 ng/mL)화건강대조조(24.7±7.3 ng/mL)현저승고(P<0.001).Pca조술후혈청HMGB1(55.0±11.0 ng/mL)교술전현저강저(P=0.005);Pca조냉동치료후,복발자술후HMGB1평균치위(70.8±2.7)ng/mL,무복발자술후HMGB1평균치위(55.0±10.8) ng/mL,차이유통계학의의(P=0.001);3례원처전이환자혈청HMGB1수평교9례국부복발자현저승고(94.2±17.9 vs.73.1±7.9 ng/mL).술후혈청HMGB1상비PSA예측복발성Pca적민감성고(83.3%Vs.66.7%),이량자연합진단적특이성교단일PSA고(95.6%vs.82.4%).Pca조술후HMGB1표체여림상분기、복발화전이(P<0.001)상관,여Gleason평분무현저상관성(P>0.05).결론:혈청HMGB1재Pca중고표체,제시혈청HMGB1가작위일항예측화예후지표.차외,Pca환자냉동치료후연합검측HMGB1화PSA대우복발환자가제고조기진단솔,유효적지도병리천자활검급후속치료.
Objective:This study aimed to investigate the expression of serum HMGB1 and prostate-specific antigen (PSA) in di-agnosing the recurrence of localized prostate cancer (Pca) in patients who had undergone cryotherapy treatment. Methods: En-zyme-linked immunosorbent assay (ELISA) was performed to measure the serum HMGB1 levels of 80 prostate cancer patients pre-and post-operation, as well as the PSA levels in 30 benign prostatic hyperplasia (BPH) and 20 healthy subjects. During follow-up, PSA anal-ysis, MRI, and pathology biopsy confirmed nine cases of local recurrence and three cases of metastasis. The post-operative serum HMGB1 expression and its diagnosis value in Pca recurrence were also determined. Results:First, the HMGB1expression level in Pca (94.0 ± 77.4 ng/mL) was significantly higher than those in BPH (33.2 ± 7.4 ng/mL) and healthy (24.7 ± 7.3 ng/mL) subjects (P<0.001). Second, post-operative serum HMGB1 was 55.03 ± 11.00 ng/mL, which significantly differed from the pre-operative level (P=0.005).Post-operative serum HMGB1 in the recurrence group significantly different from that in the recurrence-free group (70.8 ± 2.7 vs. 55.0 ± 10.8 ng/mL). Serum HMGB1 in the three metastatic cases were significantly higher than in the nine cases of local recurrence (94.2 ± 17.9 vs. 73.1 ± 7.9 ng/mL). The single diagnostic value of serum HMGB1 was more sensitive than PSA in predicting the recurrence of Pca after local treatment (83.3%vs. 66.7%), and the overall diagnostic specificity was higher than that of PSA alone (95.6%vs. 82.4%). Third, serum HMGB1 in Pca patients after cryotherapy was related to the clinical stage and recurrence (P<0.001), but was not correlated with the Gleason score. Conclusion:Our findings indicated that serum HMGB1 levels were higher in Pca sub-jects, suggesting that serum HMGB1 can be used as a predictive and prognostic factor. Moreover, co-detection of serum HMGB1 and PSA can improve the early diagnosis of Pca recurrence after cryotherapy.