Clinical Significance Of Red Blood Cell Distribution Width And PSCA SNP In Patients Undergone Prostate Biopsy

Prostate cancer(PCa) is one of the most common maglignant tumors in urinary system and it is a serious threat to the health of older men. Risk factors for PCa is not yet clear, the basic methods of the current clinical diagnosis of PCa include digital rectal examination, prostate-specific antigen(PSA) and transrectal ultrasound examination, and prostate biopsy under transrectal ultrasound is the gold standard of early diagnosis of PCa. With the popularity of PCa screening, the number of patients undergoing prostate biopsy is increasing, however, the positive rate of prostate biopsy is relatively low in our country. That means some patients suffer from unnecessary prostate biopsy. Therefore, the study about the factors which could influence the positivity of prostate biopsy has great scientific and clinical significance.This study consists of two parts: In the first part, we detected the red blood cell distribution width(RDW) of patients undergoing prostate biopsy to assess the clinical significance of RDW in patients undergoing prostate biopsy; The second part, we also analyzed prostate stem cell antigen(PSCA) gene polymorphism of the patients to investigate the association between single nucleotide acid polymorphism(SNP) of PSCA and prostate cancer(PCa) in patient undergone prostate biopsy. Part I Clinical significance of red blood cell distribution width in patients undergone prostate biopsyPurpose: The aim of this study was to assess the clinical significance of red blood cell distribution width(RDW) in patients undergoing prostate biopsy.Materials and Methods: The differences of RDW, PSA, HB, WBC, PLT, TG and age between patients with PCa and those with BPH were analyzed. Logistic regression was used to evaluate the effect of factors such as RDW, PSA, HB and age on prostate biopsy. Areas under operating characteristic curves(AUC) were used to compare the predictive power of RDW for the presence of PCa among different PSA groups. The difference of RDW level was analyzed in different groups divided by PSA, Gleason score and clinical stage and simple linear regression analysis was performed to explore the association of RDW with PSA, Gleason score and clinical stage in PCa patients. We selected early PCa patients according to stage at diagnosis(2002 AJCC TNM classification) and assess the clinical significance of RDW in early PCa patients.Results:The pathological findings showed 359 cases with prostate cancer(PCa) and 434 cases with benign prostate hyperplasia(BPH). The RDW was(13.38±1.107)% in patients with PCa which was higher than(12.75±0.62)% in those with BPH(P<0.001). The odds ratio(OR) of RDW was larger than that of PSA and age(OR was 2.440, 1.061 and 1.017 respectively) according to the Logistic regression analysis. AUC of RDW(AUCRDW) was 0.730 in the patients with PSA>20ng/ml, the highest in the PSA groups(PSA<10ng/ml, AUCRDW=0.560; PSA 10~20ng/ml, AUCRDW=0.639), with statistically significant difference(P<0.05). The RDW of PCa patients in different PSA groups; Gleason score groups and clinical stage groups was with statistically significant difference(P<0.05) respectively. The RDW was positively correlated with high risks evaluated by PSA, Gleason Score or clinical stage. The OR showed the highest value of 2.547(P<0.001) when RDW was correlated with early stage PCa according to the Logistic regression analysis.Conclusions: 1. RDW in patients with PCa is higher than in patients with BPH. 2. RDW is the independent factor affecting prostate biopsy results, which can be used to predict positive prostate biopsy, especially in patients with PSA>20ng/ml. 3. RDW can be used to evaluate the risks of prostate cancer. 4. OR of RDW is the highest in detecting early stage prostate cancer.Part II The preliminary study of prostate stem cell antigen gene polymorphism in patients undergone prostate biopsyPurpose: To investigate the association between single nucleotide acid polymorphism(SNP) of prostate stem cell antigen(PSCA) and prostate cancer(PCa) in patients undergone prostate biopsy.Materials and Methods: DNA from 144 patients undergoing prostate biopsy was typed for PSCA rs1045531 polymorphism. The frequency of rs1045531 polymorphism between PCa patients and benign prostatic hyperplasia(BPH) patients were compared, and the risk of PCa in different rs1045531 genotypes was analyzed. The associations between gene polymorphism and the age, prostate specific antigen(PSA) and Gleason scores were also analyzed.Results: Frequencies of PSCA rs1045531 genotypes in PCa cases were significantly different from those in BPH(P=0.036). Patients carrying the AC had a significantly higher risk for PCa compared to patients with CC genotype(OR=2.383,95%CI=1.198-4.741,P=0.013). The PSA in patients carrying AC was significantly higher than that in patients carrying CC.Conclusions: PSCA rs1045531 AC is associated with increased risk of PCa and PSA. These findings suggest a possibility of using PSCA rs1045531 AC as a tumor marker in the diagnosis and prognosis evaluation of PCa.