背景与目的：雄激素受体（androgen receptor，AR）辅助因子失调将激活AR并直接促进前列腺癌的发生、发展。Zimp7（human zinc finger—containing，MiZl，PIAS-1ike protein on chromosome7）是一新发现的AR辅助因子，本研究的前期工作证实，其在中国前列腺癌组织标本中高表达，预示着其可能是前列腺癌的一种特异性标志物。本研究旨在探讨尿液中Zimp7在前列腺癌早期诊断中的应用价值。方法：收集97例患者的尿液标本，其中42例前列腺癌患者，50例前列腺良性病变患者，5例膀胱癌患者。采用实时荧光定量PeR技术（real—time quantitative polymerase chain reaction，RT—PeR）检测Zimp7mRNA的表达。结果：当前列腺特异抗原（prostate specific antigen，PSA）为4-10ng／mL时Zimp7的受试者工作特征曲线下面积（AUC）为0．850（P=0．002），Zimp7阂值设定为53．00时其诊断前列腺癌的灵敏度、特异度、阳性预测值、阴性预测值分别为77．8％、84．6％、63．6％和91．7％；当不进行PSA分层时，Zimp7的AUC值为0．684（P=-0．004）；当阈值设定为17．26时，其灵敏度、特异度、阳性预测值、阴性预测值分别为66．7％、63．0％、60．5％和69．0％。另外，未发现Zimp7与年龄、pSA值和Gleason值之间有显著相关性。结论：检测尿液中Zimp7mRNA是一种无创的、可行的前列腺癌早期诊断方法。
The global incidence of metabolic syndrome （MetS） is dramatically increasing. Considerable interest has been devoted to the relationship between MetS and prostate cancer （PCa） risk. However, few studies have examined the association between MetS and PCa progression. This retrospective study consisted of 1016 patients with PCa who received radical prostatectomy. The association between MetS and pathological features was evaluated using logistic regression analysis. Compared with patients without MetS, those with MetS indicated an increased risk of prostatectomy Gleason score （GS）≥8 （odds ratio [OR] =1.670, 95% confidence interval （CI） 1.096-2.545, P = 0.017）, and a 1.5-fold increased risk of pT3-4 disease （OR = 1.583, 95% CI 1.106-2.266, P = 0.012）. The presence of MetS was an independent predictor of lymph node involvement （OR = 1.751, 95% CI 1.038-2.955, P = 0.036）. Furthermore, as the number of MetS components accumulated, the risk of a GS ≥ 8 increased. The present study indicates a significant association between MetS and advanced PCa. The results need to be evaluated in large-scale prospective cohorts.
Gui-Ming ZhangYao ZhuDa-Hai DongCheng-Tao HanCheng-Yuan GuWei-Jie GuXiao-Jian QinLi-Jiang SunDing-Wei Ye
