首段和中段尿中前列腺小体外泄蛋白对慢性前列腺炎诊断价值的比较
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摘要
目的:通过检测首段和中段尿的前列腺小体外泄蛋白(PSEP)来评估其在慢性前列腺炎(CP)诊断中的临床价值,并比较两段尿中的PSEP含量是否存在差异。方法:纳入研究对象为2017年11月至2018年5月门诊就诊的患者358例,其中临床诊断为CP 269例,正常89例,ELISA法检测其首段和中段尿标本中的PSEP。分别计算首段和中段尿PSEP检测的灵敏度、特异度、总符合率等指标,绘制受试者工作特征(ROC)曲线,比较PSEP检测与临床诊断结果的差异,同时比较两段尿中的PSEP含量之间的差异。结果:首段尿中的PSEP含量为(3. 82±3. 74) ng/ml,中段尿中的PSEP含量为(3. 77±3. 90) ng/ml,两者无明显差异(P=0. 46)。首段和中段尿PSEP检测对CP的诊断灵敏度为81. 41%、86. 99%,特异度为89. 89%、88. 76%,总符合率为83. 52%、87. 43%。结论:首段和中段尿检测PSEP均可以作为临床辅助诊断CP的指标,其诊断敏感度和特异性均较强。
Objective: To detect the contents of prostaticexosomal protein( PSEP) in the first-and mid-stream urine and assess their clinical value in the diagnosis of chronic prostatitis( CP). Methods: This study included358 male outpatientsat Nanjing General Hospital from November 2017 to May 2018,269 diagnosed with and the other 89 without CP. Wemeasured the contents of PSEP in the first-and mid-stream urine samples collected from the subjectsby ELISA anddetermined the sensitivity and specificity,and total coincidence rate ofthe PSEPcontents 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 CPbetween the PSEP detection method and clinical diagnostic criteria. Results: 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%. Conclusion: Both the content of PSEP in the first-stream and that in the mid-stream urine can be used as auxiliarydiagnostic indicators of chronic prostatitis,bothwith high sensitivity and specificity.
Objective: To detect the contents of prostaticexosomal protein( PSEP) in the first-and mid-stream urine and assess their clinical value in the diagnosis of chronic prostatitis( CP). Methods: This study included358 male outpatientsat Nanjing General Hospital from November 2017 to May 2018,269 diagnosed with and the other 89 without CP. Wemeasured the contents of PSEP in the first-and mid-stream urine samples collected from the subjectsby ELISA anddetermined the sensitivity and specificity,and total coincidence rate ofthe PSEPcontents 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 CPbetween the PSEP detection method and clinical diagnostic criteria. Results: 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%. Conclusion: Both the content of PSEP in the first-stream and that in the mid-stream urine can be used as auxiliarydiagnostic indicators of chronic prostatitis,bothwith high sensitivity and specificity.
引文
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[5]张凯,白文俊,商学军,等,泌尿男科医师应用《CUA前列腺炎诊断治疗指南》诊疗CPPS的调查.中华男科学杂志,2013,19(2):127-131.
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[9] Cho SY,Choi K,Jeon JH,et al. Differential alternative splicing of human transglutaminase 4 in benign prostate hyperplasia and prostate cancer. Exp Mol Med,2010,42(4):310-318.
[10] Li X,Jiang T,Liu F,et al. Clinical evaluation of urine prostatic exosomal protein in the diagnosis of chronic prostatitis. Urol Int,2018,100(1):112-118.
[11] Watanabe T,Inoue M,Sasaki K,et al. Nerve growth factor level in the prostatic fluid of patients with chronic prostatitis/chronic pelvic pain syndrome is correlated with symptom severity and response to treatment. BJU Int,2011,108(2):248-251.
[12] Wei X,Zhang G,Yuan H,et al. Detection and quantitation of soluble B7-H3 in expressed prostatic secretions:A novel marker in patients with chronic prostatitis. J Urol,2011,185(2):532-537.
[13] Soric T,Selimovic M,Bakovic L,et al. Clinical and biochemical influence of prostatic stones. Urol Int,2017,98(4):449-455.
[14]杨志超,杨建军,曾燕,等.前列腺小体外泄蛋白(PSEP)在慢性前列腺炎诊断中的临床应用.东南大学学报(医学版),2017,36(5):800-803.
[15]邵雪峰,李晓君,刘锋,等,NIH-Ⅲb型前列腺炎患者尿液前列腺小体外泄蛋白的测定及诊断评价.现代泌尿外科杂志,2016,21(11):861-863.
[16]曾燕,张娇,陈艳华,等,前列腺小体外泌蛋白ELISA检测方法的建立和初步评价.实用医药杂志,2015,32(10):885-888.
[2] Clemens JQ,Meenan RT,O'Keeffe Rosetti MC,et al. Prevalence of and risk factors for prostatitis:Population based assessment using physician assigned diagnoses. J Urol,2007,178(4Pt 1):1333-1337.
[3] Polackwich AS,Shoskes DA. Chronic prostatitis/chronic pelvic pain syndrome:A review of evaluation and therapy. Prostate Cancer Prostatic Dis,2016,19(2):132-138.
[4]陈智彬,宋永胜,崔军,等,慢性前列腺炎/慢性骨盆疼痛综合征对男性健康的影响.中华男科学杂志,2009,15(12):1108-1111.
[5]张凯,白文俊,商学军,等,泌尿男科医师应用《CUA前列腺炎诊断治疗指南》诊疗CPPS的调查.中华男科学杂志,2013,19(2):127-131.
[6] Aalberts M,Stout TA,Stoorvogel W. Prostasomes:Extracellular vesicles from the prostate. Reproduction,2013,147(1):R1-R14.
[7] Bjartell A,Montironi R,Berney DM,et al. Tumour markers in prostate cancer II:Diagnostic and prognostic cellular biomarkers.Acta Oncol,2011,50(Suppl 1):76-84
[8] Graddis TJ,Mc Mahan CJ,Tamman J. Prostatic acid phosphatase expression in human tissues. Int J Clin Exp Pathol,2011,4(3):295-306.
[9] Cho SY,Choi K,Jeon JH,et al. Differential alternative splicing of human transglutaminase 4 in benign prostate hyperplasia and prostate cancer. Exp Mol Med,2010,42(4):310-318.
[10] Li X,Jiang T,Liu F,et al. Clinical evaluation of urine prostatic exosomal protein in the diagnosis of chronic prostatitis. Urol Int,2018,100(1):112-118.
[11] Watanabe T,Inoue M,Sasaki K,et al. Nerve growth factor level in the prostatic fluid of patients with chronic prostatitis/chronic pelvic pain syndrome is correlated with symptom severity and response to treatment. BJU Int,2011,108(2):248-251.
[12] Wei X,Zhang G,Yuan H,et al. Detection and quantitation of soluble B7-H3 in expressed prostatic secretions:A novel marker in patients with chronic prostatitis. J Urol,2011,185(2):532-537.
[13] Soric T,Selimovic M,Bakovic L,et al. Clinical and biochemical influence of prostatic stones. Urol Int,2017,98(4):449-455.
[14]杨志超,杨建军,曾燕,等.前列腺小体外泄蛋白(PSEP)在慢性前列腺炎诊断中的临床应用.东南大学学报(医学版),2017,36(5):800-803.
[15]邵雪峰,李晓君,刘锋,等,NIH-Ⅲb型前列腺炎患者尿液前列腺小体外泄蛋白的测定及诊断评价.现代泌尿外科杂志,2016,21(11):861-863.
[16]曾燕,张娇,陈艳华,等,前列腺小体外泌蛋白ELISA检测方法的建立和初步评价.实用医药杂志,2015,32(10):885-888.