血液Rce1蛋白在前列腺癌诊断中的临床意义

Clinical significance of blood Rce1 protein in the diagnosis of prostate cancer

摘要:

目的：探索血液中Ras转化酶1（Ras and a-factor converting enzyme 1，Rce1）蛋白在前列腺癌（prostate cancer，PCa）诊断中的意义。方法：收集2017年4月至2018年10月经病理确诊的共96例PCa患者和133例良性前列腺增生（benign prostatic hyperplasia，BPH）患者的血液标本，进行Western blot和酶联免疫吸附测定法（enzyme-linked immunosorbent assay，ELISA）检测，30例泌尿结石、隐睾、精索静脉曲张患者作为对照组，分析评价血液中Rce1浓度值诊断PCa的效能。结果：3组间血液Rce1水平差异具有统计学意义。PCa组血液Rce1浓度值[（93.25±15.14） pg/μL]明显高于BPH组[（78.37±16.91） pg/μL]和对照组[（77.73±12.04） pg/μL ]（P=0.000）；而BPH组和对照组间差异无统计学意义（P=0.843）。同时PCa患者血液Rce1浓度值高低与Gleason评分及N分期呈正相关（P=0.030，P=0.039）。血液Rce1截断值为74.98 pg/μL时最佳，其敏感性和特异性分别为89.7%、46.3%。血Rce1与前列腺特异抗原（prostate specific antigen，PSA）联合诊断曲线下面积（area under the curve，AUC）高于单独应用（P=0.000）。结论：血液Rce1蛋白检测有助于提高PCa的早期筛查率，联合应用PSA能够提高PCa的诊断效能，Rce1可能作为PCa筛查和判断预后的新标志物。

Abstract:

Objective：To explore the clinical significance of Ras and a-factor converting enzyme 1（Rce1） in the diagnosis of prostate cancer（PCa）. Methods：Blood samples from 96 patients with PCa and 133 patients with benign prostatic hyperplasia（BPH） as con－firmed by pathology from April 2017 to October 2018 were collected for Western blot and enzyme-linked immunosorbent assay （ELISA）. Meanwhile，another 30 patients with urinary calculi，cryptorchidism，and varicocele were treated as normal control group. Then levels of Rce1 in the blood specimens from these groups were analyzed to evaluate its performance in the diagnosis of PCa. Results：The PCa group had a significantly higher level of Rce1 compared with those of the BPH group and normal control group（93.25±15.14 pg/μL vs. 78.37±16.91 pg/μL and 77.73±12.04 pg/μL，P=0.000）. However，there was no significant difference between the BPH and normal control group regarding the level of Rce1（P=0.843）. Meanwhile，the level of Rce1 was positively cor－related with Gleason score and N stage（P=0.030，P=0.039）. With the optimal cut-off value of 74.98 pg/μL，Rce1 had a sensitivity of 89.7% and a specificity of 46.3%. The area under the receiver operating characteristic curve of combined diagnosis with Rce1 and prostate specific antigen（PSA） was higher than each diagnostic method alone（P=0.000）. Conclusion：Blood Rce1 test is helpful to improve the early diagnosis rate of PCa，and Rce1 combined with PSA also can improve the diagnostic efficiency of PCa. Therefore，Rce1 is deemed as a new marker for the screening for and prognosis of PCa.