中文摘要：

目的 检测血清前列腺特异性抗原（prostate-specific antigen,PSA）升高患者microRNA-4286（miR-4286）的表达情况,探讨其在前列腺癌诊断中的意义。方法 选择2016年3月至8月第二军医大学长海医院日间手术病区收治的171例血清PSA升高、行前列腺穿刺活检的患者,采用q PCR技术检测miR-4286在血清中的表达,比较前列腺癌（50例）和良性前列腺病变（121例）患者miR-4286表达的差异。并且分析10例良性病变患者术前与术后3 d的血清miR-4286的表达变化,以及15例PCa患者的术前与术后3 d及8例术前与术后7 d的血清miR-4286的表达变化。以受试者工作特征曲线分析评价miR-4286对PCa的诊断效能。结果 MiR-4286在前列腺癌和良性前列腺病变患者中的表达水平差异有统计学意义（P〈0.05）。术后3 d前列腺癌患者miR-4286的表达水平升高,与术前相比差异有统计学意义（P〈0.05）,术后3 d良性前列腺病变患者miR-4286的表达水平与术前相比差异无统计学意义（P〉0.05）;术后7 d miR-4286在前列腺癌患者中的表达水平与术前相比差异无统计学意义（P〉0.05）。MiR-4286和PSA在前列腺癌中的诊断效能分别为曲线下面积（AUC）0.653（界值3.72,敏感性68.75%,特异性60.06%）和0.733（界值11.38 ng/m L,敏感性57.16%,特异性92.35%）。结论 MiR-4286在前列腺癌中具有良好的诊断价值,可作为新型的液体活检标志物。

英文摘要：

Objective To explore the diagnostic significance of microRNA-4286 （miR-4286） for prostate cancer through detecting its expression in patients with an elevated serum prostate-specific antigen （PSA） level. Methods We selected 171 patients with an elevated serum PSA level who underwent prostate biopsy at Day Ward between Mar. 2016 and Aug. 2016 in Changhai Hospital of Second Military Medical University; we determined and compared the expression of serum miR-4286 in 50 patients with prostate cancer and 121 with benign prostate diseases by qPCR assay. The serum miR-4286 levels were analyzed at pre-operation and three-day post-operation in 10 patients with benign prostate disease and 15 patients with prostate cancer, and at pre-operation and seven-day post-operation in 8 cases with prostate cancer. The receiver operating characteristic curve was used to evaluate the diagnostic performance of miR-4286 for prostate cancer. Results The expression of miR-4286 showed a significant difference between the prostate cancer and benign prostatic disease patients （P〈0.05）. The expression of 3-day post-operative miR-4286 was significantly elevated compared with pre-operation in the prostate cancer patients （P〈0.05）; there was no significant difference in the expression of miR-4286 between pre-and 7 days post-operation in the prostate cancer patients （P〉0.05） or between pre-and 3 days post-operation in the benign prostatic disease patients （P〉0.05）. The areas under curve of the miR-4286 and PSA were 0.653 （cut-off value 3.72, sensitivity 68.75%, specificity 60.06%） and 0.733 （cut-off value 11.38 ng/mL, sensitivity 57.16%, specificity 92.35%）, respectively. Conclusion miR-4286 has a good diagnostic value and may be a new biomarker for liquid-biopsy in prostate cancer.