Expression And Clinical Value Of Peripheral Blood PCA3 MRNA In Patients With Prostate Cancer

Objective: We aim to study the expression level of PCA3 m RNA in peripheral blood of prostate cancer patients and to analyze its value in early diagnosis of prostate cancer with prostate specific antigen(PSA)gray area(4~10ng/ml).We investigated the relationship between the expression of PCA3 m RNA in peripheral blood and the pathological grade of prostate cancer,and evaluated the clinical significance of PCA3 m RNA in peripheral blood as a monitoring index of endocrine therapy for prostate cancer.Methods: The peripheral blood of 103 cases prostate cancer patients and 73 cases benign prostatic hyperplasia(BPH)diagnosed and treated in urology of our hospital from September 2016 to June 2018 were collected.The expression of PCA3 m RNA in peripheral blood was detected by real-time fluorescence quantitative PCR(Taqman probe(FQ-PCR probe).We have analyzed the difference of PCA3 m RNA expression in peripheral blood of patients with PSA gray area,and studied the role of peripheral blood PCA3 m RNA in the early diagnosis of prostate cancer.We have analyzed the relationship between the expression of PCA3 m RNA in peripheral blood of patients with prostate cancer and Gleason score of prostate cancer,the number of positive needles of prostate cancer puncture and the volume of cancer tissue,and explored the role of peripheral blood PCA3 m RNA in predicting the pathological grade of cancer.We have analyzed the difference of PCA3 m RNA expression in peripheral blood before and after 3 months of endocrine therapy,and evaluated the role of PCA3 m RNA in peripheral blood as a monitoring index for the treatment of prostate cancer.Outcome: 1.There are 40 patients that the levels of serum PSA were between4ng/ml~10ng/ml,including 15 patients with prostate cancer and 25 patients with benign prostatic hyperplasia.There was significant difference in the expression of PCA3 m RNA in peripheral blood between prostate cancer patients and benign prostatic hyperplasia patients(Z = 2.94 P ? 0.003).We draw the ROC curve,the area under the curve(AUC)of peripheral blood PCA3 m RNA and serum PSA is 0.755 VS 0.555 respectively,the maximum Jordan index of peripheral blood PCA3 m RNA is 0.48,the corresponding sectional value is 3.875,the sensitivity and specificity for the diagnosis of prostate cancer in PSA grey interval were 60% and 88% respectively.2.The expression of PCA3 m RNA in peripheral blood was analyzed in different Gleason score groups.It was found that the expression of PCA3 m RNA in peripheral blood of patients with Gleason score ? 8 was significantly higher than that of patients with Gleason score ? 7(Z =-5.94 P < 0.001),there was a positive correlation between PCA3 m RNA and Gleason score(r ? 0.661,p < 0.01).The expression of PCA3 m RNA in peripheral blood was analyzed in different prostate cancer puncture positive needle groups.It was found that the expression of PCA3 m RNA in peripheral blood of patients with puncture positive needle number > 4 needles was significantly higher than that of patients with puncture positive needle number ? 4 needles(Z =-7.88 P < 0.001),there was a positive correlation between peripheral blood PCA3 m RNA and the number of puncture positive needles(r ? 0.783,p < 0.01).We analysised of peripheral blood PCA3 m RNA in different volume of cancer tissue,found that the expression of PCA3 m RNA in peripheral blood of patients with cancer tissue volume > 0.5cm3 was significantly higher than that of patients with cancer tissue volume ? 0.5cm3(Z =-4.89 P < 0.001),there was a positive correlation between peripheral blood PCA3 m RNA and prostate tumor volume(r = 0.714,P < 0.01).P < 0.01).3.The expression of PCA3 m RNA in peripheral blood of patients with prostate cancer before and after endocrine therapy was analyzed.it was found that the expression of PCA3 m RNA in peripheral blood of patients with prostate cancer decreased significantly after endocrine therapy(Z =-4.54 P < 0.001).Conclusion: 1.The high expression of PCA3 m RNA in peripheral blood has early diagnostic value for prostate cancer patients with serum PSA gray area;2.The higher the expression of PCA3 m RNA in peripheral blood,the higher the pathological grade of prostate cancer,and the more positive needle number of prostate cancer puncture.The larger the volume of cancer tissue,the greater the malignant degree of cancer cells,indicating the worse the prognosis;3.Peripheral blood PCA3 m RNA is expected to be a monitoring index of endocrine therapy for prostate cancer.