外周血和组织炎性细胞在鉴别PSA 4～10 ng/ml的前列腺癌和前列腺增生中的临床意义
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摘要
目的:评价外周血和前列腺组织炎性细胞在鉴别前列腺特异性抗原(PSA)4～10 ng/ml的前列腺癌(PCa)和良性前列腺增生(BPH)中的临床意义。方法:回顾性分析我院2013年10月～2018年10月PSA水平4～10 ng/ml的PCa和BPH患者共45例,其中PCa组患者20例,BPH组患者25例。PCa组患者行前列腺癌根治术后病理确诊,BPH组患者行耻骨上经膀胱前列腺摘除术或经尿道前列腺电切术(TURP)后病理确诊。所有患者在行前列腺穿刺活检术前检测血常规,记录患者外周血中WBC、中性粒细胞、淋巴细胞和单核细胞计数,分析外周血淋巴细胞与单核细胞比率(LMR)、中性粒细胞与单核细胞比率(NMR)和中性粒细胞与淋巴细胞比率(NLR)等。同时收集患者术后病理石蜡切片,采用免疫组织化学(IHC)染色法检测前列腺组织中炎性细胞表达情况。结果:PCa组和BPH组患者外周血白细胞、中性粒细胞和淋巴细胞计数等指标比较差异无统计学意义。PCa组单核细胞计数明显低于BPH组,差异有统计学意义(P<0.05)。两组LMR、NMR和NLR值比较差异无统计学意义。两组淋巴细胞和中性粒细胞表达比较差异无统计学意义,但BPH组单核细胞标志物CD14表达高于PCa组,差异有统计学意义(P<0.05)。结论:检测外周血和组织中单核细胞计数有助于诊断PSA浓度4～10 ng/ml的PCa患者。
Objective: To evaluate clinical significance of inflammatory cells in blood and tissue of PCa and BPH patients with PSA level 4-10 ng/ml. Method: A total of 45 patients with initial PSA level 4-10 ng/ml, including 20 PCa and 25 BPH patients, were enrolled for retrospective analysis at our department between October 2013 and October 2018. All the patients were diagnosed by histopathology after radical prostatectomy in PCa patients and open prostatectomy or TURP in BPH patients. Blood was collected before biopsy for detecting peripheral blood cell counts, including WBC, neutrophil, lymphocyte and monocyte, and the values of LMR, NMR and NLR were analyzed. The samples of prostate tissues from surgery were collected for observing inflammatory cells by IHC staining. Result: The mean WBC, neutrophil and lymphocyte counts in peripheral blood had no significant difference between PCa group and BPH group. However, the mean monocyte count was obviously less in PCa group than that in BPH group(P<0.05). The values of LMR, NMR and NLR had no significant difference between two groups. On the other hand, the counts of lymphocyte and neutrophil had no obvious difference between PCa and BPH tissues. However, the expression of monocyte marker CD14 dramatically increased in BPH tissue than that in PCa tissue(P<0.05). Conclusion: Detecting monocyte count in serum and tissues is beneficial to the diagnosis of PCa with PSA 4-10 ng/ml.
Objective: To evaluate clinical significance of inflammatory cells in blood and tissue of PCa and BPH patients with PSA level 4-10 ng/ml. Method: A total of 45 patients with initial PSA level 4-10 ng/ml, including 20 PCa and 25 BPH patients, were enrolled for retrospective analysis at our department between October 2013 and October 2018. All the patients were diagnosed by histopathology after radical prostatectomy in PCa patients and open prostatectomy or TURP in BPH patients. Blood was collected before biopsy for detecting peripheral blood cell counts, including WBC, neutrophil, lymphocyte and monocyte, and the values of LMR, NMR and NLR were analyzed. The samples of prostate tissues from surgery were collected for observing inflammatory cells by IHC staining. Result: The mean WBC, neutrophil and lymphocyte counts in peripheral blood had no significant difference between PCa group and BPH group. However, the mean monocyte count was obviously less in PCa group than that in BPH group(P<0.05). The values of LMR, NMR and NLR had no significant difference between two groups. On the other hand, the counts of lymphocyte and neutrophil had no obvious difference between PCa and BPH tissues. However, the expression of monocyte marker CD14 dramatically increased in BPH tissue than that in PCa tissue(P<0.05). Conclusion: Detecting monocyte count in serum and tissues is beneficial to the diagnosis of PCa with PSA 4-10 ng/ml.
引文
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13 Gurel B,Lucia M S,Thompson I M Jr,et al.Chronic inflammation in benign prostate tissue is associated with high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial[J].Cancer Epidemiol Biomarkers Prev,2014,23(5):847-856.
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15 Ceylan Y,Günlüsoy B,Degirmenci T,et al.Neutrophil-to-lymphocyte and neutrophil-to-monocyte rates in the decision for a prostate re-bopsy in patients with a previous benign pathology and consistently 2.5-10 ng/ml PSA value[J].Arch Esp Urol,2016,69(9):627-635.
16 Elzanaty S,Rezanezhad B,Borgquist R.Association between PSA Levels and Biomarkers of Subclinical Systemic Inflammation in Middle-Aged Healthy Men from the General Population[J].Curr Urol,2016,9(3):148-152.
17 Gallo L.The Effect of a Pure Anti-inflammatory Therapy on Reducing Prostate-specific Antigen Levels in Patients Diagnosed With a Histologic Prostatitis[J].Urology,2016,94:198-203.
2 Loeb S,Bjurlin M A,Nicholson J,et al.Overdiagnosis and overtreatment of prostate cancer[J].Eur Urol,2014,65(6):1046-1055.
3 Bishayee A.The role of inflammation and liver cancer[J].Adv Exp Med Biol,2014,816:401-435.
4 Kundu J K,Surh Y J.Inflammation:gearing the journey to cancer[J].Mutat Res,2008,659(1-2):15-30.
5 Wang K,Karin M.Tumor-Elicited Inflammation and Colorectal Cancer[J].Adv Cancer Res,2015,128:173-196.
6 Platz E A,Kulac I,Barber J R,et al.A prospective study of chronic inflammation in benign prostate tissue and risk of prostate cancer:linked PCPT and SELECT cohorts[J].Cancer Epidemiol Biomarkers Pre,2017,26(10):1549-1557.
7 Arthur R,Williams R,Garmo H,et al.Serum inflammatory markers in relation to prostate cancer severity and death in the Swedish AMORIS study[J].Int J Cancer,2018,142(11):2254-2262.
8 Oh J J,Kwon O,Lee J K,et al.Association of the neutrophil-to-lymphocyte ratio and prostate cancer detection rates in patients via contemporary multi-core prostate biopsy[J].Asian J Androl,2016,18(6):937-941.
9 Sun Z,Ju Y,Han F,et al.Clinical implications of pretreatment inflammatory biomarkers as independent prognostic indicators in prostate cancer[J].J Clin Lab Anal,2018.
10 Kaynar M,Yildirim M E,Gul M,et al.Benign prostatic hyperplasia and prostate cancer differentiation via platelet to lymphocyte ratio[J].Cancer biomarkers,2015,15(3):317-323.
11 Chen R,Huang Y,Cai X,et al.Age-Specific Cutoff Value for the Application of Percent Free Prostate-Specific Antigen(PSA)in Chinese Men with Serum PSA Levels of 4.0-10.0 ng/ml[J].PLoS One,2015,10(6):e0130308.
12 Xu N,Wu Y P,Chen D N,et al.Can Prostate Imaging Reporting and Data System Version 2 reduce unnecessary prostate biopsies in men with PSA levels of 4-10 ng/ml?[J].J Cancer Res Clin Oncol,2018,144(5):987-995.
13 Gurel B,Lucia M S,Thompson I M Jr,et al.Chronic inflammation in benign prostate tissue is associated with high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial[J].Cancer Epidemiol Biomarkers Prev,2014,23(5):847-856.
14 Vasavada S R,Dobbs R W,Kajdacsy-Balla A A,et al.Inflammation on Prostate Needle Biopsy is Associated with Lower Prostate Cancer Risk:A Meta-Analysis[J].J Urol,2018,199(5):1174-1181.
15 Ceylan Y,Günlüsoy B,Degirmenci T,et al.Neutrophil-to-lymphocyte and neutrophil-to-monocyte rates in the decision for a prostate re-bopsy in patients with a previous benign pathology and consistently 2.5-10 ng/ml PSA value[J].Arch Esp Urol,2016,69(9):627-635.
16 Elzanaty S,Rezanezhad B,Borgquist R.Association between PSA Levels and Biomarkers of Subclinical Systemic Inflammation in Middle-Aged Healthy Men from the General Population[J].Curr Urol,2016,9(3):148-152.
17 Gallo L.The Effect of a Pure Anti-inflammatory Therapy on Reducing Prostate-specific Antigen Levels in Patients Diagnosed With a Histologic Prostatitis[J].Urology,2016,94:198-203.