Nakashima J, Ozu C, Nishiyama T, Oya M, Ohigashi T, Asakura H, Tachibana M, Murai M
Department of Urology, Keio University School of Medicine, Shinjukuku, Tokyo, Japan.
Urology. 2000 Nov 1;56(5):843-7. doi: 10.1016/s0090-4295(00)00755-x.
To assess the prognostic significance of alkaline phosphatase (ALP) flare in 114 patients with metastatic prostate cancer treated with endocrine therapy.
ALP flare was defined as a transient increase of the serum ALP level to 120% or more of the pretreatment value after the initiation of endocrine therapy, followed by a subsequent decrease.
Univariate analysis demonstrated that patients with poorly differentiated adenocarcinoma, an extent of disease of 2 or greater, a serum ALP level above twice the upper limit of normal, a serum prostate-specific antigen level greater than 100 ng/mL, an ALP flare, and a hemoglobin level of 12 g/dL or less had a significantly lower survival rate than their respective counterparts. Multivariate Cox's proportional hazards model analysis demonstrated that tumor histologic features and ALP flare were significant prognostic indicators for survival.
The results of the present study suggest that the tumor histologic features and the ALP flare are significant prognostic indicators for survival in patients with metastatic prostate cancer treated with endocrine therapy.
评估114例接受内分泌治疗的转移性前列腺癌患者中碱性磷酸酶（ALP）升高的预后意义。
ALP升高定义为内分泌治疗开始后血清ALP水平短暂升高至治疗前值的120%或更高，随后下降。
单因素分析表明，低分化腺癌、疾病范围为2级或更高、血清ALP水平高于正常上限两倍、血清前列腺特异性抗原水平大于100 ng/mL、ALP升高以及血红蛋白水平为12 g/dL或更低的患者生存率显著低于各自的对照组。多因素Cox比例风险模型分析表明，肿瘤组织学特征和ALP升高是生存的重要预后指标。
本研究结果表明，肿瘤组织学特征和ALP升高是接受内分泌治疗的转移性前列腺癌患者生存的重要预后指标。
