回顾性分析初诊前列腺癌患者发生骨转移的危险因素。

Retrospective analysis of risk factors for bone metastasis in newly diagnosed prostate cancer patients.

机构信息

Department of Urology, Department of Oncology, General Hospital of Northern Theater Command PLA, Liaoning, People's Republic of China.

出版信息

Eur Rev Med Pharmacol Sci. 2022 Jun;26(11):3832-3839. doi: 10.26355/eurrev_202206_28950.

DOI:10.26355/eurrev_202206_28950

PMID:35731052

Abstract

OBJECTIVE

The aim of the study was to analyze the clinical data of newly diagnosed prostate cancer (PCa) patients with bone metastasis and to explore the relevant risk factors.

PATIENTS AND METHODS

The clinical data of 251 patients with PCa, who were initially diagnosed in our hospital from February 2015 to October 2021, were retrospectively analyzed. According to the whole-body bone scan results, patients were divided into the bone metastasis group (n = 66) and the non-bone metastasis group (n = 185). The patient's age, total prostate-specific antigen (TPSA), free PSA (fPSA), prostate volume, alkaline phosphatase (ALP), Gleason score, erythrocyte sedimentation rate (ESR), and pelvic lymph node metastasis were collected. Univariate correlation and multivariate regression analyses, together with receiver operating characteristic curve, were used to analyze PCa bone metastasis-related factors.

RESULTS

The incidence of bone metastasis in newly diagnosed PCa was about 26.29% (66/251). Among them, the incidence of pelvic metastasis was the highest, at 78.78% (52/251), and multiple bone metastases were significantly higher than single bone metastasis (80.31% vs. 19.69%). Univariate correlation analysis indicated that age, Gleason score, ESR, TPSA, ALP, fPSA/PSA, capsular infiltration, and pelvic lymph node metastasis (p < 0.05) were highly correlated with PCa bone metastasis. Multivariate Logistic regression analysis showed that TPSA (95% CI: 0.977-1.284, p = 0.007), ALP (95% CI: 1.008-1.080, p = 0.016), Gleasons core (95% CI: 2.110-82.349, p = 0.006), ESR (95% CI: 1.062-1.104, p = 0.003), and pelvic lymph node metastasis (95% CI: 1.537--33.239, p = 0.012) were independent risk factors for bone metastasis of PCa. The cut-off values for TPSA, ALP, Gleason score, and ESR were 33.78 ng/ml, 73.65 U/L, 7.5, and 23.5 mm/h, respectively. Additionally, the respective sensitivities for TPSA, ALP, Gleason score, and ESR were 81.8%, 75.8%, 68.2% and 77.3%, and the respective specificities was 90.3%, 98.9%, 98.4%, and 74.6%.

CONCLUSIONS

TPSA, ALP, Gleason score, ESR and pelvic lymph node metastasis are independent risk factors for bone metastasis of PCa.

摘要

目的

分析新诊断前列腺癌（PCa）伴骨转移患者的临床资料，探讨相关危险因素。

方法

回顾性分析 2015 年 2 月至 2021 年 10 月我院收治的 251 例初诊 PCa 患者的临床资料。根据全身骨扫描结果，将患者分为骨转移组（n=66）和非骨转移组（n=185）。收集患者年龄、总前列腺特异性抗原（TPSA）、游离前列腺特异性抗原（fPSA）、前列腺体积、碱性磷酸酶（ALP）、Gleason 评分、红细胞沉降率（ESR）、盆腔淋巴结转移等临床资料。采用单因素相关性分析和多因素回归分析，并结合受试者工作特征曲线分析 PCa 骨转移的相关因素。

结果

新诊断 PCa 患者骨转移发生率约为 26.29%（66/251）。其中，盆腔转移发生率最高，为 78.78%（52/251），且多发骨转移明显高于单发骨转移（80.31%比 19.69%）。单因素相关性分析显示，年龄、Gleason 评分、ESR、TPSA、ALP、fPSA/PSA、包膜浸润和盆腔淋巴结转移（p<0.05）与 PCa 骨转移高度相关。多因素 Logistic 回归分析显示，TPSA（95%CI：0.977-1.284，p=0.007）、ALP（95%CI：1.008-1.080，p=0.016）、Gleason 评分（95%CI：2.110-82.349，p=0.006）、ESR（95%CI：1.062-1.104，p=0.003）和盆腔淋巴结转移（95%CI：1.537-33.239，p=0.012）是 PCa 骨转移的独立危险因素。TPSA、ALP、Gleason 评分和 ESR 的截断值分别为 33.78ng/ml、73.65U/L、7.5 分和 23.5mm/h。此外，TPSA、ALP、Gleason 评分和 ESR 的敏感度分别为 81.8%、75.8%、68.2%和 77.3%，特异度分别为 90.3%、98.9%、98.4%和 74.6%。