Detection of telomerase activity in prostate massage samples improves differentiating prostate cancer from benign prostatic hyperplasia
Detection of telomerase activity in prostate massage samples improves differentiating prostate cancer from benign prostatic hyperplasia
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DOI：
10.1007/s00432-003-0525-8
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发表时间：
2004-04-01
影响因子：
3.6
通讯作者：
Bologna, M
中科院分区：
文献类型：
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作者：
Vicentini, C;Gravina, GL;Bologna, M
目的.我们进行了一项病例对照研究，在该研究中，我们测试了一种非侵入性检测方法检测端粒酶活性的能力，并在前列腺按摩后获得的上皮细胞样本上区分前列腺癌（Pca）和良性前列腺增生（BPH）。方法.端粒重复序列扩增法（TRAP）检测端粒酶活性。我们选择了60例经组织学证实的前列腺癌（30例）或前列腺增生（30例）患者。本研究中纳入的样本来自直肠指检无可疑癌症发现、有下尿路症状临床证据、经直肠超声评价时无Pca超声体征、总PSA值中度升高（2.6-15 ng/ml）且无其他泌尿系癌症证据的患者。整个过程在病理学家和分子生物学操作员之间以双盲方式进行。结果Pca组端粒酶活性阳性率为90%，BPH组为13%。计算出该方法的敏感性（90%）和特异性（76%）。阳性预测值、阴性预测值和诊断效率分别为87%、90%和88%。结论我们的数据表明，前列腺按摩收集的前列腺上皮细胞上的TRAP检测端粒酶活性可以大大提高Pca和BPH条件之间的区别。使用这种新的检测方法的临床益处之一是改进活检适应症，并避免一些没有Pca的患者的不必要的费用和前列腺活检的并发症。
Purpose. We performed a case-control study in which we tested the ability of a non-invasive assay to detect telomerase activity and to distinguish between prostatic cancer (Pca) and benign prostatic hyperplasia (BPH) on samples of epithelial cells obtained after prostatic massage. Methods. Telomerase activity was determined by a telomeric repeat amplification protocol (TRAP) assay. We selected 60 patients with histologically proven Pca (30 cases) or BPH (30 cases). Specimens included in this study were from patients who had no suspicious findings on digital rectal examination for cancer, had clinical evidence of lower urinary tract symptoms, had no sonographic signs of Pca at the transrectal ultrasound evaluation, had total PSA values moderately elevated (2.6-15 ng/ml), and had no evidence of other urological cancers. The whole procedure was conducted in double blind between pathologists and molecular biology operators. Results. Telomerase activity was detected in 90% of Pca cases and in 13% of BPH cases. The sensitivity (90%) and specificity (76%) of this method were calculated. The positive predictive value, negative predictive value, and diagnostic efficiency were 87%, 90%, and 88% respectively. Conclusion. Our data indicate that telomerase activity detected by TRAP assay on prostate epithelial cells collected by prostate massage can substantially improve the distinction between Pca and BPH conditions. One of the clinical benefits resulting from the use of this new assay would be to refine the biopsy indication and to avoid for several patients without Pca the unnecessary cost and the complications of prostate biopsy.