目的：研究前列腺组织中DD3 mRNA及DD3 mRNA／D定量检测在前列腺特异性抗原（ PSA）灰区前列腺癌临床诊断中的应用价值。方法选择sPSA 4～10 ng／ml的前列腺增生（ BPH）患者112例和前列腺癌（ PC）患者25例，进行RT-PCR、PSA检测、B型超声检查及前列腺穿刺活检。观察其DD3 mRNA、DD3 mRNA／D、血清PSA（ sP-SA）、前列腺穿刺活检标本PSA（uPSA）、总PSA／游离PSA比值（f／tPSA）、s／uPSA、PSA密度（PSAD）等参数的差异，并应用ROC曲线分析各参数的诊断价值。结果2组患者年龄、前列腺体积比较差异无统计学意义（ t ＝12滗．87、12．31， P ＞0．05）；tPSA、PSAD比较差异均有统计学意义（ t ＝7．31、6．89， P ＜0．05）；PC组DD3 mRNA／PSA mRNA比值明显高于BPH 组（ t ＝7．86， P ＝0．009）；PC组DD3 mRNA／D比值明显高于BPH组（ t ＝7．28， P ＝0．05）。 ROC曲线分析结果表明，以0．27为截断值，DD3 mRNA／PSA mRNA的曲线下面积为0．841（95％CI 0．666～0．997）；以2．01为截断值，DD3 mRNA／D的曲线下面积为0．907（95％CI 0．790～0．869）。结论 DD3 mRNA含量、DD3 mRNA／D定量检测可以显著提高检出PSA灰区前列腺癌的敏感度，对PSA灰区前列腺癌的早期筛查诊断意义重大，DD3 mRNA／D具有更好的诊断效能。%Objective To study the expression of DD3 mRNA and DD3 mRNA/D in the diagnosis of prostate cancer in PSA gray zone.Methods One hundred and twelve patients with sPSA 4 -10 ng /ml of benign prostatic hyperplasia ( BPH) and 25 cases of prostate cancer ( PC) were enrolled, RT-PCR and PSA were test, B type ultrasonography and biopsy of prostate were performed.Observed the difference of the DD3 mRNA, DD3 mRNA/D, serum PSA( sPSA) , prostate punc-ture biopsy specimens of PSA ( uPSA) , total /free PSA ratio ( f/tPSA) , s/uPSA, PSA density ( PSAD) etc.parameters, and used ROC curve to analyze the diagnostic value of each parameter.Results Two groups’ patients’ age, prostate volume showed no statistical significance differences ( t =12.87, t =12.31, P >0.05);TPSA, PSAD’ s difference showed statis-tics significance ( t =7.31, t =6.89, P <0.05);PC group’s DD3 mRNA/PSA mRNA ratio were significantly higher than that of BPH group ( t =7.86, P =0.009); PC group’ s DD3 mRNA/D ratio significantly higher than BPH group ( t =7.28, P =0.05).ROC curve analysis showed that when cut-off value was 0.27, the DD3 mRNA/PSA mRNA’s curve area was 0.841 (95%CI 0.666-0.997); when cutoff value was 2.01, the curve area of DD3 mRNA/D was 0.907 (95% CI 0.790-0.869) .Conclusion DD3 mRNA content and quantitative DD3 mRNA/D detection can significantly improve the detection sensitivity of the PSA gray zone prostate cancer, has great significance for PSA gray zone prostate cancer early screening and DD3 mRNA/D has better diagnostic efficiency.
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