Value Of Prostatic Exosomal Protein Detection For The Diagnosis Of Chronic Prostatitis

Background:Prostatitis,especially chronic prostatitis(CP),is one of the most common diseases of the male genitourinary system in adult.In recent years,the incidence and treatment rate of CP has increased year by year.More and more male's physical and mental health and quality of life are affected by CP,Its etiology and pathogenesis are very complex and not fully understood.The clinical diagnosis of CP is subjective and the current laboratory testing methods are limited.Moreover,the clinical diagnosis of CP is subjective and the current laboratory testing methods are limited.Therefore,in order to better diagnose and treat CP,more accurate and efficient diagnosis method is needed.Objective:We detect the contents of prostatic exosomal protein(PSEP)in the first and mid-stream urine and assess their clinical value of CP.Methods:This study included 358 male outpatients at our Hospital from November 2017 to May 2018,269 diagnosed with and the other 89 without CP.We measured the contents of PSEP in the first and mid-stream urine samples collected from the subject by ELISA.CP patients were divided into NIH?,NIH?A and NIH?B according to the National Institutes of Health classification criteria.The differences in PSEP contents between the first and mid-stream urine samples of CP patients and normal healthy men were compared.We determined the sensitivity and specificity,and total coincidence rate of the PSEP contents in the diagnosis of CP.Using the ROC curve,we compared the PSEP levels in the two different urine samples and the results of diagnosis of CP between the PSEP detection method and clinical diagnostic criteria.Results:1.The normal urinary PSEP contents in normal healthy group,NIHII type,NIHIIIA type and NIHIIIB type CP group were(0.44±0.73)ng/ml,(3.51±3.89)ng/ml,(3.96±3.77).ng/ml,(4.02±3.93)ng/ml;the contents of PSEP in the mid-stream urine is(0.29±0.78)ng/ml,(3.12±3.78)ng/ml,(3.82±3.97)ng/ml,(3.68±3.90)ng/ml.There was a significant difference between the first and middle urinary PSEP and the normal healthy male group in each subtype of CP(P<0.01).There was no significant difference between the first and middle urinary PSEP in each subtype of CP(P>0.05).2.No statistically significant difference was observed between the contents of PSEP in the first and mid-stream urine samples([3.82±3.74]vs[3.77±3.90]ng/ml,P=0.46).In the diagnosis of CP,the PSEP contents in the first and mid-stream urine samples manifested a sensitivity of 81.41%vs,86.99%,a specificity of 89.89%vs 88.76%,and a total coincidence rate of 83.52%vs 87.43%.The consistency test results of PSEP and clinical diagnosis in the first and mid-stream urine were Kappa= 0.62 and 0.69,respectively.The area under the ROC curve of the first and middle urinary PSEP was 0.92 and 0.93,respectively.Conclusion:Both the contents of PSEP in the first and mid-stream urine can be used as a clinical auxiliary diagnosis indicators of CP,both with high sensitivity and specificity.