The Expression Of PCA3 And PSA Gene In Peripheral Blood And Urine And The Significance Of Urine PCA3 Score For Diagnosis Of Prostate Cancer

Objective PCA3 gene is a specific gene of PCa. To detect the expression of PCA3 and PSA gene in peripheral blood and urine , PCA3 and PSA were investigated to become new diagnosis markers whether or not and their clinical significance were explored in clinical stage and pathological grade.Methods (1) From June 2009 to December 2009, the initial prostate massage urine after digital rectal examination and the peripheral blood specimens was collected from 37 cases with PCa and 68 cases with BPH that were confirmed by pathology,8 cases with urinary stone were used as normal control.β-actin mRNA as control gene ,the relative copy number of expression of PCA3 and PSA mRNA in urine sediments and peripheral blood mononuclear cells were detected by fluorescence real-time quantitative PCR. PCa patients were divided into three subgroups according to serum tPSA values :< 4 ng/ml 5 cases ,4-10 ng / ml 3 cases, > 10 ng/ml 29 cases;they were divided into two subgroups according to Gleason score, 5-7 score 13 cases, 8-10 score 24 cases;they were divided into three subgroups according to the clinical Whitmore- Jewett stage: stage B 22 cases, stage C 6 cases, stage D 9 cases. BPH patients were divided into three groups according to serum tPSA values:<4 ng/ml 22 cases,4-10 ng / m1 19 cases, > 10 ng/ml 27 cases.ResultsⅠThe expression of PCA3 and PSA gene in peripheral blood and urine1,The expression of PCA3 gene in peripheral blood and urine1.1 PCA3 mRNA in peripheral blood in the control and the BPH group were undetectable. PCA3 mRNA were detectable in 18 cases in PCa group and the expression of PCA3 was 82.61±167.56;the sensitivity and specificity were respectively 48.6% and 100%;The positive rate of PCA3 mRNA in group with Gleason score 8-10 was statistically significantly higher than in group with Gleason score 5-7 (P<0. 05). The positive rate of PCA3 mRNA in group with stage C / D was higher than in group with stage B (P<0. 05).1.2 Expression of PCA3 mRNA in Urine was 7.47±7.86 in the control group ,it was 8.32±12.01 in BPH and it was 60.31±68.53 in PCa group;2,The expression of PSA gene in peripheral blood and urine2.1 PSA mRNA in peripheral blood in the control group were undetectable. PSA mRNA were detectable in 7 cases in the BPH group and the expression of PSA mRNA was 15.89±67.95;PSA mRNA were detectable in 19 case in PCa group and the expression of PSA mRNA in PCa group was 98.81±148.76;the sensitivity and specificity were respectively 51.4% and 90.8%;The positive rate of PSA mRNA in group with Gleason score 8-10 was not statistically significantly higher than in group with Gleason score 5-7 (P>0. 05). The positive rate of PSA mRNA in group with stage C /D was statistically significantly higher than in group with stage B (P<0. 05);2.2 Expression of PSA mRNA in Urine was 412.74±273.62 in the control group ,it was 398.24±364.12 in BPH group and it was 392.47±361.22 in PCa group(P>0. 05);ⅡUrine PCA3 score1 ROC curve analysis was performed for the PCA3 score and the area under the ROC curve was0.908(95%CI:0.854 to0.969). Using 64.6 as the cutoff, there were 30 cases in PCa group above cut-off, the sensitivity was 81.1%.There were 66 cases in BPH and the control group and the specificity was 86.8%.The positive predictive value and negative predictive value were respectively 75% and 90.4%.2 Urine PCA3 score in PCa, BPH and control group were respectively 174.44±121.32, 31.08±36.99 and 13.5±11.9.3 In 5 cases in PCa with serum tPSA values < 4ng/ml,there were 4 case were diagnosed as PCa by the PCA3 score and the positive rate is 80%; In 3 cases of prostate cancer with serum tPSA values was 4-10 ng/ml,there were 2 cases were diagnosed as PCa by the PCA3 score and the positive rate is 66.7%; In 27 cases of BPH with serum tPSA values was >10 ng/ml,there were 22 cases were confirmed by the PCA3 score and the negative rate was 81.5%. The PCA3 score could diagnose for PCa with serum tPSA values < 4 ng/ml and 4-10 ng/ml and delete PCa from people with serum tPSA levels >10 ng/ml. 4 The PCA3 score of group with Gleason score 5-7 were 200±130.65 and the PCA3 score of group with Gleason score 8-10 were 107±63.1 .The difference between the two groups was significant (P = 0.029). The PCA3 score had well relation with Gleason score (rs′= 0.029, P = 0.027) .The PCA3 score of group with clinical stage D were 288.3±119.2,the PCA3 score of group with clinical stage C were 196±108.3 and the PCA3 score of group whose clinical stage B were 110. 5±72.4. The difference among the three groups was significant (P = 0.01). The PCA3 score had well relation with clinical stage ( rs′= 0.561, P = 0.000);5 The sensitivity of simultaneous detection for PCA3 mRNA in peripheral blood and urinary PCA3 score were 86.5%. Conclusion 1,The expression of PCA3 and PSA in Peripheral blood were a evidently specific marker of PCa , especially PCA3 were undetectable in peripheral blood in BPH and other urinary patients and specificity was 100%.2,Urinary PCA3 score had a better clinical value in the diagnosis of PCa than serum tPSA .The simultaneous detection for PCA3 mRNA in peripheral blood and urinary PCA3 score not only could increase the sensitivity for the diagnosis of PCa, but also had significant correlation with different pathological grades and clinical stages of PCa;3,The expression of PCA3 and PSA in urine and in Peripheral blood can be well detected by Real-time quantitative PCR;...