2015 年第 5 期 第 13 卷

良性前列腺增生及前列腺癌的ADC值与PAP、P504S、PSA表达的相关性研究

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关键词：良性前列腺增生，前列腺癌，表观扩散系数，PAP，P504S，PSA

• 摘要：
• 【摘要】目的 探讨良性前列腺增生和前列腺癌的ADC值与前列腺相关标记物PAP、P504S、PSA表达的相关性的关系。方法 收集经病理证实65例前列腺疾病患者，其中良性前列腺增30例，前列腺癌35例，取病理检查前3个月内均行前列腺MRI、DWI检查，采用单次激发EPI序列，b值为0s/mm2和800s/mm2，并采用免疫组化检测组织标本中PAP、P504S、PSA的表达，分析ADC值与PAP、P504S、PSA表达的关系。结果 良性前列腺增生和前列腺癌的ADC值分别为(1.73±0.21)×10-3mm2/s和(1.34±0.15)×10-3mm2/s，差异具有统计学意义（t=8.545，P=0.000)。PAP和PSA在良性前列腺增生和前列腺癌均表达，差异没有统计学意义（P均>0.05），P504S在癌中的表达显著高于良性增生（Z=-7.055，P=0.000），双变量相关分析显示ADC值与P504S的表达呈显著负相关且相关关系密切（Spearman＇s 相关系数r=-0.654，P=0.000）；结论PAP和PSA不能区别前列腺良恶性病变；P504S可以作为前列腺癌标记物；ADC值可以定量评价良性前列腺增生和前列腺癌，且与P504S存在密切负相关关系， 可以作为前列腺良恶性病变MRI诊断的参考指标。
• Objective To investigate the correlation between apparent diffusion coefficient (ADC) and PAP, P504S, PSA expression in benign prostatic hyperplasia (BPH) and prostate cancer (Pca). Methods 65 cases of prostate lesions proved by pathology were presented in this study. in which there were 30cases of BPH and 35 cases of Pca. DWI (b-values=0.s/mm2 and 800 s/mm2) images were obtained for all cases at Siemens Sonata 1.5T and the expression of PAP, P504S, PSA were estimated with SP immunohistochemical technique individually. Results The mean ADC values of BPH and Pca were (1.73±0.21)×10-3mm2/s and (1.34±0.15)×10-3mm2/s, there were statistical significant differences between them (t=8.545，P=0.000). The expression of PAP and PSA were no significant difference between BDH and Pca (both P>0.05). The expression rate of P504S in Pca was apparently higher than that in BPH (Z=-7.055，P=0.000), Bivariate analysis showed that ADC were positively correlated with P504S (Spearman’s correlation coefficient r=-0.654, P =0.000). Conclusion PAP and PSA can't distinguish the benign and malignant lesions of prostate. P504S can be used as a specific biomarker for prostate cance. ADC value can quantitatively evaluate the differences of BPH and pca, and have a close inverse correlation with P504S, so it is play an important reference role in diagnosis the benign and malignant lesions of prostate of MRI．