VPAC 受体阳性与 mp-MRI 在前列腺癌诊断中的比较:初步研究

IF 1.6 Q3 UROLOGY & NEPHROLOGY
BJUI compass Pub Date : 2025-04-22 DOI:10.1002/bco2.70006
Nishant Setya, Shridhar C. Ghagane, Rajendra B. Nerli, Ashwin Bokare, Madhukar L. Thakur, Leonard Gomella
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引用次数: 0

摘要

目的 该研究旨在对具有下尿路症状且血清 PSA 为 4 但 15 纳克/毫升的男性患者(年龄≥40 岁)进行前瞻性评估,与多参数磁共振成像(mp-MRI)相比,利用排空的尿液样本和针对基因组 VPAC(血管活性肠肽和垂体腺苷酸环化酶激活肽)受体诊断 PCa 的可行性。 患者和方法 研究对象为泌尿科就诊的男性患者,年龄≥40 岁,有下尿路症状,血清 PSA 水平为 4 但 15 纳克/毫升。研究人员收集了排出的尿液样本,以检测恶性细胞上的 VPAC 受体。所有患者都接受了 mp-MRI 检查。所有患者均接受了 12 核经直肠超声引导的前列腺活组织检查,并比较检查结果以诊断 PCa。 结果 共有 61 名患者接受了尿液生物标记物评估和 mp-MRI 进一步评估,中位年龄为 65.33±8.11 岁,中位血清 PSA 为 9.56±2.78 纳克/毫升。经组织病理学(HPR)确诊为 PCa 的患者有 25 人(40.98%),其余 36 人(59.01%)为良性前列腺增生。在 25 例经组织学证实为 PCa 的患者中,24 例(96%)的尿液生物标志物(VPAC 阳性)呈恶性肿瘤阳性,1 例呈假阴性(4%),无假阳性病例(0%)。有 3/16 例患者的 PIRADS 评分为 2 分,7/21 例患者的 PIRADS 评分为 3 分,7/14 例患者的 PIRADS 评分为 4 分,8/8 例患者的 PIRADS 评分为 5 分,HPR 证实为 PCa。 结论 前列腺癌细胞的 VPAC 受体阳性是一种使用排空尿液样本进行的简便检测方法。对于既往活检阴性但高度怀疑癌症的患者、血清 PSA 升高但数字直肠检查正常的患者,以及具有良性特征但血清 PSA 略有升高的患者,VPAC 受体阳性可作为前列腺活检的指征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

VPAC receptor positivity in comparison with mp-MRI in the diagnosis of prostate cancer: A preliminary study

VPAC receptor positivity in comparison with mp-MRI in the diagnosis of prostate cancer: A preliminary study

Objective

The study aimed to prospectively evaluate the feasibility of diagnosing PCa using voided urine samples and by targeting the genomic VPAC (vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide) receptors in comparison with multiparametric magnetic resonance imaging (mp-MRI) in male patients (≥40 years of age) with lower urinary tract symptoms and having a serum PSA of >4 but <15 ng/ml.

Patients and Methods

Male patients attending urological services ≥40 years old, with lower urinary tract symptoms and serum PSA levels of >4 but <15 ng/ml formed the study group. Voided urine samples were collected to target VPAC receptors on malignant cells. All patients underwent mp-MRI. A 12-core transrectal ultrasound-guided prostate biopsy was performed in all, and the results were compared for the diagnosis of PCa.

Results

A total of 61 patients with a median age of 65.33 ± 8.11 years and with a median serum PSA of 9.56 ± 2.78 ng/ml were further evaluated with both urinary biomarker assessment and mp-MRI. Histopathological (HPR) confirmation of PCa was noted in 25 (40.98%) patients and benign prostatic hyperplasia in the remaining 36 (59.01%) patients. Of the 25 patients with histologically proven PCa, the urinary biomarker (VPAC positivity) was positive for malignancy in 24 (96%), one case showed false negative results (4%) and there were no false positive cases (0%). HPR confirming PCa was seen in 3/16 patients with a PIRADS 2 score, 7/21 patients with a PIRADS 3 score, 7/14 patients with a PIRADS 4 score and 8/8 patients with a PIRADS score of 5.

Conclusions

VPAC receptor positivity of prostate cancer cells is an easy test to perform using a voided urine sample. VPAC receptor positivity can be used as an indication for prostate biopsy in patients having a negative previous biopsy but highly suspicious of cancer, in patients with an elevated serum PSA but with a normal digital rectal examination and in patients with benign features and borderline elevation of serum PSA.

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