摘要目的 研究尿液exosomal miR-375在前列腺癌中的表达及临床应用价值.方法 收集45例前列腺癌患者、24例前列腺增生患者、24名健康对照者的尿液,提取尿液中的exosomal RNA.应用实时荧光定量聚合酶链反应(qRT-PCR)检测尿液exosomal miR-375的表达量,并采用全面的统计方法探讨miR-375对前列腺癌的临床价值.结果 前列腺癌尿液exosomal miR-375的表达量较BPH和健康对照组明显下调,差异有统计学意义(P＜0.01).但miR-375在BPH组和对照组中的表达差异无统计学意义(P＞0.05).尿液exosomal miR-375的表达与临床分期和骨转移相关(P＜0.05),随着临床分期的增加,miR-375的表达水平降低;但miR-375的表达量与患者年龄、Gleason评分和血清前列腺特异性抗原水平相关性不强(P＞0.05).ROC曲线显示尿液exosomal miR-375较PSA能够更好地区分前列腺癌与BPH,曲线下面积分别为0.715(95％ CI:0.589 ～0.842)、0.632(95％ CI:0.492 ～0.771).结论 尿液exosomal miR-375可作为前列腺癌非侵入性的分子诊断标志物.

abstractsObjective To analyze the expression of urine exosomal miR-375 in prostate tumors and investigate its clinical utility.Methods A total of 45 patients with PCa,24 with benign prostate hyperplasia (BPH) and 24 healthy individuals were enrolled into this study.Exosomes were isolated from the urine of PCa,BPH and healthy individuals and the total RNA was extracted from the exosomes.The exosomal miR-375 expression was assessed by quantitative real-time PCR and analyzed with the comparative quantification cycle method (2-△△CT).We performed comprehensive biostatistical analyses to explore the clinical value of miR-375 in prostate cancer.Results The urine exosomal miR-375 expression was significantly downregulated in the patients with PCa compared with BPH and the healthy controls (P ＜ 0.01).No statistically significant difference of the urine exosomal miR-375 expression levels between the patients with BPH and healthy individuals was observed (P ＞ 0.05).The urine exosomal miR-375 expression level was also found to be associated with clinical stage and bone metastasis status of the patients with PCa (P ＜0.05),and with the increase of Clinical stage.The expression level of miR-375 decreased.No significant relationship was detected between miR-375 level and the patient's age,gleason score and serum prostate-specific antigen level (P ＞ 0.05).Receiver operator characteristic analyses demonstrated that the urine exosomal miR-375 expression could better differentiate PCa from BPH patients:AUC 0.715 (95％ CI:0.589-0.842) vs PSA AUC 0.632 (95％ CI:0.492-0.771) (P＜0.01).Conclusion The urine exosomal miR-375 could serve as a non-invasive biomarker for the diagnosis of PCa.