| Background According to the diagnostic criteria of the National Institute of health(NIH),chronic prostatitis/chronic pelvic pain syndromes(CP/CPPS)are NIH-III prostatitis is specifically classified into IIIA(inflammatory)and IIIB(non-inflammatory).To date,the development,pathogenesis and pathological changes of NIH-III prostatitis are still unclear.Many recent studies have shown that CC-like chemokines associated with immune mechanisms may play an important role in the development and pathological evolution of chronic prostatitis.Objective To investigate the expression and significance of human normal T cells expressing secretion-regulated activating factor(RANTES)in NIH-III prostatitis.Methods1.Collect 40 patients diagnosed with NIH-III prostatitis in our urology clinic during April 2018-June 2020 as the experimental group,after active treatment,a total of 35 cases were enrolled as the treatment group,and 20 volunteers who were previously fit were selected as the healthy control group,and all participants established medical records files and completed NIH-CPSI questionnaire,and EPS specimens obtained through prostate massage by a uniformly trained urological clinician,and then quickly sent to our laboratory for routine analysis of prostate fluid,as well as the detection of RANTES in prostate fluid by enzyme-linked immunoassay(ELISA).2.Collect 2 ml of heparin sodium anticoagulated peripheral blood from all subjects and determine the number and ratio of Th1/Th2 cells by flow cytometry.Results1.The analysis of General data There were no statistically significant differences in age or BMI between the subgroups(P>0.05).2.The differences of RANTES among different groups2.1 The level of RANTES expression in prostatic fluid was significantly increased in the group of patients with prostatitis(NIH-IIIA + NIH-IIIB)compared to healthy controls,and the difference was statistically significant(P< 0.05).2.2 The expression level of RANTES in the NIH-IIIA group was significantly higher than that in the NIH-IIIB group and the healthy control group,and the difference was statistically significant(P<0.05);there was no statistical difference between the IIIB group and the healthy control group(P>0.05).2.3 In the post-treatment group of NIH-III prostatitis,the expression of RANTES was significantly down-regulated compared with the pre-treatment level,and the difference was statistically significant(P<0.05).3.The correlation of RANTES with EPS leukocyte levels,NIH-CPSI scores,and peripheral blood Th1/Th2 cell ratios.3.1 There was no significant correlation between leukocyte levels in EPS and NIH-CPSI scores(P>0.05).3.2 RANTES was positively correlated with EPS leukocyte levels(P<0.05).3.3 RANTES was positively correlated with the NIH-CPSI score(P<0.05).3.4 RANTES was positively correlated with the Th1/Th2 cell ratio(P<0.05).4.The Diagnostic Efficacy of RANTES under Receiver Operating Characteristic Curve RANTES has high diagnostic value in NIH-III prostatitis with an area under the curve(AUC)of 0.74 and its best diagnostic cut-off value of 318.43 pg/ml for NIH-III prostatitis;it has an AUC value of 0.89 for NIH-IIIA prostatitis alone,especially in the case of NIH-IIIA prostatitis is most likely to be considered at RANTES concentrations greater than 349.16 pg/ml,at which point the specificity is 90% and the sensitivity 80%.Conclusion RANTES is strongly correlated with the severity of clinical symptoms of prostatitis and may be involved in the development of chronic prostatitis through the regulation of Th1/Th2 balance drift,suggesting that RANTES may be an independent,molecular marker capable of effectively diagnosing NIH-III prostatitis,with higher diagnostic and assessment value than EPS WBC counts. |
