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血清脂质谱:预测接受根治性前列腺切除术患者晚期前列腺癌的新型生物标志物。

Serum lipid profiles: novel biomarkers predicting advanced prostate cancer in patients receiving radical prostatectomy.

作者信息

Zhang Gui-Ming, Qin Xiao-Jian, Zhang Hai-Liang, Xiao Wen-Jun, Zhu Yao, Gu Cheng-Yuan, Dai Bo, Shi Guo-Hai, Ye Ding-Wei

机构信息

Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.

出版信息

Asian J Androl. 2015 Mar-Apr;17(2):239-44. doi: 10.4103/1008-682X.142135.

Abstract

This study aimed to evaluate the role of serum lipid profiles as novel biomarkers in predicting pathological characteristics of prostate cancer (PCa). We retrospectively analyzed 322 consecutive patients with clinically localized PCa receiving radical prostatectomy (RP) and extended pelvic lymphadenectomy. Unconditional logistic regression was used to estimate the prostatectomy Gleason score (pGS), pathological stage and lymph node involvement (LNI) in RP specimens. Preoperative prostate-specific antigen (PSA) levels, biopsy GS (bGS), and preoperative tumor, node, metastasis staging were used as basic variables to predict postoperative pathological characteristics. Preoperative serum lipid profiles were introduced as potential predictors. A receiver operating characteristic (ROC) curve was used to determine predictive efficacy. Significant differences in pathological characteristics were observed among patients with normal and abnormal total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) levels, with the exception of pGS in the TG group. Multivariable regression analysis revealed that the odds ratio for high levels of TC for LNI compared with normal TC levels was 6.386 (95% confidence interval [CI] 1.510-27.010), 3.270 (95% CI: 1.470-7.278) for high levels of TG for pT3-4 disease, and 2.670 (95% CI: 1.134-6.287) for high levels of LDL for pGS. The area under the ROC curve of the models with dyslipidemia was larger than that in models without dyslipidemia, in predicting pathological characteristics. Abnormal TC, TG, and LDL levels are significantly associated with postoperative pathological status in PCa patients. Together with preoperative PSA levels, bGS, and clinical stage, dyslipidemia is more accurate in predicting pathological characteristics.

摘要

本研究旨在评估血清脂质谱作为新型生物标志物在预测前列腺癌(PCa)病理特征中的作用。我们回顾性分析了322例连续接受根治性前列腺切除术(RP)和扩大盆腔淋巴结清扫术的临床局限性PCa患者。采用无条件逻辑回归估计RP标本中的前列腺切除术后Gleason评分(pGS)、病理分期和淋巴结转移(LNI)。术前前列腺特异性抗原(PSA)水平、活检Gleason评分(bGS)以及术前肿瘤、淋巴结、转移分期用作预测术后病理特征的基本变量。引入术前血清脂质谱作为潜在预测指标。采用受试者工作特征(ROC)曲线确定预测效能。在总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL)水平正常和异常的患者中,除TG组的pGS外,观察到病理特征存在显著差异。多变量回归分析显示,与正常TC水平相比,TC水平升高与LNI的比值比为6.386(95%置信区间[CI]1.510 - 27.010),TG水平升高与pT3 - 4疾病的比值比为3.270(95%CI:1.470 - 7.278),LDL水平升高与pGS的比值比为2.670(95%CI:1.134 - 6.287)。在预测病理特征方面,血脂异常模型的ROC曲线下面积大于无血脂异常模型。TC、TG和LDL水平异常与PCa患者术后病理状态显著相关。与术前PSA水平、bGS和临床分期一起,血脂异常在预测病理特征方面更准确。

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