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。 Objective To detect the expression of microRNA-4286 (miR-4286) in patients with elevated serum prostate-specific antigen (PSA), and to explore its significance in the diagnosis of prostate cancer. METHODS: A total of 171 patients with elevated serum PSA who underwent prostate biopsy from March 2016 to August 2016 in Changhai Hospital of the Second Military Medical University were enrolled in this study. Q-PCR was used to detect the expression of miR-4286 in serum. The difference of miR-4286 expression in patients with prostate cancer (50 cases) and benign prostatic diseases (121 cases) was compared. The expression of miR-4286 in preoperative and postoperative 3 d of 10 patients with benign lesions was analyzed, and the serum levels of miR-4286 in preoperative and postoperative 3 d and 8 preoperative and postoperative 7 d of 15 PCa patients were analyzed. 4286 expression changes. The diagnostic performance of miR-4286 on PCa was evaluated using the receiver operating characteristic curve analysis. Results The expression level of MiR-4286 in patients with prostate cancer and benign prostatic diseases was significantly different (P <0.05). The expression level of miR-4286 in prostate cancer patients increased 3 days after operation, which was significantly different from that before operation (P <0.05). The expression of miR-4286 in patients with benign prostatic disease at 3 days after operation was significantly lower than that in preoperative (P> 0.05). The expression level of miR-4286 in prostate cancer patients at 7 days after operation was not significantly different from that before operation (P> 0.05). The diagnostic efficacy of MiR-4286 and PSA in prostate cancer was 0.653 (AUC) of 0.653 (borderline 3.72, 68.75% sensitivity, 60.06% specificity) and 0.733 (borderline 11.38 ng / mL, respectively, with a sensitivity of 57.16 %, Specificity 92.35%). Conclusion MiR-4286 has a good diagnostic value in prostate cancer and can be used as a new type of liquid biopsy marker.