PO.CL01.19 · 临床研究
一种替代血清前列腺特异性抗原的前列腺癌筛查方法
An alternative screening method for prostate cancer to serum prostate specific antigen
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
引言:经过23年的随访,Roobol等人最近的一项长期研究显示,在接受前列腺癌筛查的一组人群中,相对死亡率降低了13%,绝对风险降低了0.22%(DOI: 10.1056/NEJMoa2503223)。大多数前列腺癌(ProC)不致命,致命肿瘤的死亡率约为15%,而大多数为较惰性的肿瘤。前列腺特异性抗原(PSA)血液检测用于筛查,但在4-10ng/mL的灰区内,阳性预测率仅为25%,导致不必要的侵入性活检。一种更有效的非侵入性检测将会有益。
方法:采集了自行收集的、未刺激的唾液。使用Adnab-9单克隆抗体(mAb)进行点印迹p87检测,记录结合值减去背景值。该mAb与胃肠道中通常与潘氏细胞分泌相关的分泌产物发生反应。
结果:如下图所示,在ProC患者中,唾液p87显著低于非癌症对照(p<0.005)。我们发现唾液产物(如血液溶菌酶、血液和粪便癌症生物标志物)之间存在相关性。乳腺癌患者唾液中的p87(0.031±0.01)显著高于前列腺癌患者唾液中的p87(p<0.031)。
结论:较低浓度的唾液溶菌酶已被发现与其他胃肠道和造血系统癌症相关(Sun等,https://doi.org/10.1155/2016/8701423)。通过更大的样本量,我们希望能够表明降低水平的唾液p87、溶菌酶和其他生物标志物或许能够检测更具侵袭性的ProC,从而减少不必要的侵入性操作和焦虑。
查看英文原文 English abstract
Introduction: After 23 years of follow-up, a recent long-term study by Roobol et al showed a relative reduced mortality rate of 13% and an absolute risk reduction of 0.22% in a group screened for prostate cancer (DOI: 10.1056/NEJMoa2503223). Most prostate cancers (ProC) are not lethal and the death rate is about 15% for lethal tumors versus a majority of more indolent tumors. Prostate Specific Antigen (PSA) blood test is used for screening, but within the grey zone of 4-10ng/mL the positive predictive rate is only 25%, leading to unnecessary invasive biopsies. A more effective non-invasive test would be beneficial.
Methods: Self-collected, unstimulated saliva was obtained. A dot blot p87 assay was performed using Adnab-9 monoclonal antibody (mAb) with binding minus background recorded. The mAb reacts with secretory products in the GI tract usually associated with Paneth cell secretions.
Results: In the figure below, in patients with ProC, the salivary p87 was significantly lower than non-cancer controls (p<0.005). We found correlations between salivary products such as blood lysozyme, blood, and stool cancer biomarkers. p87 saliva in breast cancer patients was significantly higher (0.031±0.01) than in prostate cancer patients' saliva ( p<0.031).
Conclusions: Lower concentrations of salivary lysozyme have been found to be associated with other GI and hemopoietic cancers (Sun et al. https://doi.org/10.1155/2016/8701423 ). With larger numbers we hope to show that reduced levels of salivary p87, lysozyme, and other biomarkers might be able to detect more aggressive ProC, reducing unnecessary invasive procedures and anxiety.
利益披露 Disclosure
Y. Tobi, None.