Combined detection of CXCL16, PSAD and fPSA% for the clinical diagnosis of prostate cancer with PSA in diagnostic gray zone

doi:10.3877/cma.j.issn.1674-3253.2020.03.003

Abstract

Abstract:

Objective

To evaluate the combined diagnostic value of Chemokine ligand 16 (CXCL16) , serum PSA, fPSA% and PSAD in patients with prostate cancer in the gray area of PSA.

Method

A retrospective analysis was perfomed with 81 cases of patients who were treated from January 2017 to January 2018 in Guangdong Provincial People's Hospital, and their PSA were between 4-10 μg/L (diagnostic gray zone). Among these patients, 24 patients with prostate cancer (Tumor group) and 57 patients with benign prostatic lesions (Benign group) were enrolled. Urine specimens were deposited in all patients prior to surgery. The levels of CXCL16 in the urine samples of each group were determined by enzyme-linked immunosorbent assay (ELISA). Meanwhile, serum PSA levels in each group were determined by chemiluminescence method and analyzed statistically. The diagnostic efficacies of CXCL16 in urine samples were evaluated by the ROC curve and the area under the cure (AUC).

Results

The non-parametric rank sum test of PSA, fPSA%, PSAD and CXCL16 in the Tumor group and the Benign group showed that there were statistically significant differences in fPSA%, PSAD and CXCL16 (P<0.01), while there was no statistically significant difference in PSA level between two groups (P=0.709).The area under curve (AUC) of PSAD, fPSA%, CXCL16 and the combined test for the diagnosis of prostate cancer, which was 0.684, 0.6447, 0.7105 and 0.8157, respectively. The diagnostic sensitivity and specificity of CXCL16 were 62.5% and 78.9% respectively at a cutoff of 2.4 ng/L.

Conclusion

As a novel tumor biomarker, quantitative detection of CXCL16 in urine can be used in the screening and diagnosis of prostate cancer. The combination of PSAD, fPSA% and CXCL16 is beneficial for the early diagnosis of prostate cancer in patients whose PSA in diagnostic gray zone.

Key words: Prostate cancer, PSA gray zone, CXCL16, Tumor biomarker

Jianxiong Fang, Jiumin Liu, Xiaoyong Pu, Haosheng Liu, Tianqi Liu, Xiewu Zhang, Chujin Ye. Combined detection of CXCL16, PSAD and fPSA% for the clinical diagnosis of prostate cancer with PSA in diagnostic gray zone[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(03): 171-175.

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References 18

[1]	Mark S, Litwin MM, Hung-Jui Tan MM. The Diagnosis and Treatment of Prostate Cancer A Review[J]. JAMA, 2017, 24(317): 2532-2542.
[2]	韩苏军. 中国前列腺癌发病及死亡现状和流行趋势分析[D]. 北京：北京协和医学院中国医学科学院, 2015[2016年5月4日]. URL
[3]	中华医学会泌尿外科学分会. 2014中国泌尿外科疾病诊断治疗指南[S]. 2014[2014-06-17], URL
[4]	Richardsen E, Ness N, Melbø-Jørgensen C, et al. The prognostic significance of CXCL16 and Its receptor C-X-C chemokine receptor 6 in prostate cancer[J]. Am J Pathol, 2015, 185(10): 2722-2730.
[5]	Ha HK, Lee W, Park HJ, et al. Clinical significance of CXCL16/CXCR6 expression in patients with prostate cancer[J]. Mol Med Rep, 2011, 4(3): 419-424.
[6]	Darash-Yahana M, Gillespie J W, Hewitt S M, et al. The chemokine CXCL16 and its receptor, CXCR6, as markers and promoters of inflammation-associated cancers[J]. PloS one, 2009, 4(8): e6695.
[7]	Lu Y, Wang J, Xu Y, et al. CXCL16 Functions as a Novel Chemotactic Factor for Prostate Cancer Cells In vitro[J]. Mol Cancer Res, 2008, 6(4): 546-554.
[8]	Hu W, Zhen X, Xiong B, et al. CXCR6 is expressed in human prostate cancer in vivo and is involved in the in vitro invasion of PC3 and LNCap cells[J]. Cancer Sci, 2008, 99(7): 1362-1369.
[9]	吴润华黄衍杨唐坚清. 趋化因子受体CXCR6及其配体CXCL16在非小细胞肺癌中的表达及临床意义[J]. 山西医科大学学报, 2017, 48(8): 830-835.
[10]	邓君, 洪华, 刘蔚, 等. MUC1基因表达和CXCL16在乳腺癌诊断中的应用[J]. 实用医院临床杂志, 2018, 15(6): 136-138.
[11]	肖欢. 血清sE-cadherin、CXCL16含量对宫颈癌病灶内恶性生物学行为的评估价值[J]. 海南医学院学报, 2017, 23(24): 3433-3436.
[12]	Lang K, Bonberg N, Robens S, et al. Soluble chemokine (C-X-C motif) ligand 16 (CXCL16) in urine as a novel biomarker candidate to identify high grade and muscle invasive urothelial carcinomas[J]. Oncotarget, 2017, 8(62): 104946-104959.
[13]	易童, 崔曙, 龚志勇, 等. 趋化因子受体6在膀胱尿路上皮癌中的表达及其临床意义[J]. 四川医学, 2015, 36(10): 1363-1367.
[14]	Singh R, Kapur N, Mir H, et al. CXCR6-CXCL16 axis promotes prostate cancer by mediating cytoskeleton rearrangement via Ezrin activation and αvβ 3 clustering[J]. oncotarget, 2016, 7(6): 7343-7353.
[15]	Jung Y, Kim JK, Shiozawa Y, et al. Recruitment of mesenchymal stem cells into prostate tumours promotes metastasis[J]. Nat Commun, 2013,4(1): 1795.
[16]	Li X, Sterling JA, Fan KH, et al. Loss of TGF- Responsiveness in Prostate Stromal Cells Alters Chemokine Levels and Facilitates the Development of Mixed Osteoblastic/Osteolytic Bone Lesions[J]. Mol Cancer Res, 2012, 10(4): 494-503.
[17]	Wang J, Lu Y, Wang J, et al. CXCR6 Induces Prostate Cancer Progression by the AKT/Mammalian Target of Rapamycin Signaling Pathway[J]. Cancer Res, 2008, 68(24): 10367-10377.
[18]	Sung SY, Hsieh CL, Law A, et al. Coevolution of Prostate Cancer and Bone Stroma in Three-Dimensional Coculture: Implications for Cancer Growth and Metastasis[J]. Cancer Res, 2008, 68(23): 9996-10003.

组别	例数	年龄（岁）	体重（kg）	前列腺体积（cm³）	肌酐（μmol/L）	CXCL16（ng/L）	PSA（μg/ml）	fPSA/tPSA（%）	PSAD
前列腺癌组	24	67(54～74)	70(68～80)	37.8(22.0～65.6)	96.5(85.9～106.5)	2.00(1.00～4.02)	7.21(5.27～8.46)	10.2(8.0～13.6)	0.32(0.12～0.49)
前列腺良性组	57	72(62～77)	65(63～70)	45.9(29.2～73.6)	84.6(74.9～89.8)	4.37(2.84～6.32)	7.51(5.57～8.63)	13.8(10.8～18.6)	0.19(0.10～0.30)
P值	-	0.124	<0.01	0.062	0.073	<0.01	0.2997	<0.01	<0.01

组别	例数	年龄（岁）	体重（kg）	前列腺体积（cm³）	肌酐（μmol/L）	CXCL16（ng/L）	PSA（μg/ml）	fPSA/tPSA（%）	PSAD
前列腺癌组	24	67(54～74)	70(68～80)	37.8(22.0～65.6)	96.5(85.9～106.5)	2.00(1.00～4.02)	7.21(5.27～8.46)	10.2(8.0～13.6)	0.32(0.12～0.49)
前列腺良性组	57	72(62～77)	65(63～70)	45.9(29.2～73.6)	84.6(74.9～89.8)	4.37(2.84～6.32)	7.51(5.57～8.63)	13.8(10.8～18.6)	0.19(0.10～0.30)
P值	-	0.124	<0.01	0.062	0.073	<0.01	0.2997	<0.01	<0.01

组别	敏感度	特异度	阳性预测值	阴性预测值	准确度
CXCL16	62.5（15/24）	78.9（45/57）	55.6（15/27）	83.3（45/54）	74.1（60/81）
fPSA%	87.5（21/24）	31.6（18/57）	0.35（21/60）	85.7（18/21）	48.1（39/81）
PSAD	0.75（18/24）	36.8（21/57）	33.3（18/54）	77.8（21/27）	48.1（39/81）
联合诊断	87.5（21/24）	68.4（39/57）	53.8（21/39）	92.9（39/42）	74.1（60/81）

组别	敏感度	特异度	阳性预测值	阴性预测值	准确度
CXCL16	62.5（15/24）	78.9（45/57）	55.6（15/27）	83.3（45/54）	74.1（60/81）
fPSA%	87.5（21/24）	31.6（18/57）	0.35（21/60）	85.7（18/21）	48.1（39/81）
PSAD	0.75（18/24）	36.8（21/57）	33.3（18/54）	77.8（21/27）	48.1（39/81）
联合诊断	87.5（21/24）	68.4（39/57）	53.8（21/39）	92.9（39/42）	74.1（60/81）

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