前列腺癌骨转移影响因素分析及血清 PSA、CysC、D-D 诊断价值

Analysis of Factors Influencing Bone Metastasis in Prostate Cancer and Diagnostic Value of Serum PSA, CysC and D-D.

机构信息

Hospital Infection Management Department, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, 266000 Qingdao, Shandong, China.

Department of Spinal Surgery, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, 266000 Qingdao, Shandong, China.

出版信息

Arch Esp Urol. 2024 Jan;77(1):72-78. doi: 10.56434/j.arch.esp.urol.20247701.10.

DOI:10.56434/j.arch.esp.urol.20247701.10

PMID:38374016

Abstract

OBJECTIVE

This study aims to analyse factors influencing bone metastasis in prostate cancer and the diagnostic value of serum prostate-specific antigen (PSA), and D-dimer (D-D) combined with cystatin C (CysC) in bone metastasis of prostate cancer.

METHODS

Data of 116 patients with prostate cancer admitted to our hospital were retrospectively analysed. They were divided into two groups: Bone metastasis group (46 cases) and non-bone metastasis group (70 cases). Univariate and multivariate logistic regression analyses were used to determine factors influencing bone metastasis in prostate cancer. The values of serum PSA, D-D and CysC were identified using a receiver operating characteristic diagnostic curve.

RESULTS

Of the 116 patients, 46 had bone metastases and 70 had non-bone metastases. Among 46 patients with bone metastasis, 8 cases (17.39%) had single bone metastasis and 38 cases (82.61%) had multiple bone metastasis. Based on the univariate analysis, bone metastasis was associated with increases in Gleason score, clinical stage, lymph node metastasis, systemic inflammatory response index, fibrinogen to albumin ratio and alkaline phosphatase and fibrinogen levels. The Gleason score was higher than 8 points, the clinical stages ranged from T3 to T4 and the serum levels of PSA, D-D and CysC were higher in the bone metastasis group ( < 0.05). The combined value of serum PSA, D-D and CysC in the diagnosis of bone metastasis in prostate cancer was higher than the three indicators alone.

CONCLUSIONS

Lymph node metastasis in T3-T4 clinical stages with Gleason score >8 was a risk factor for bone metastasis in prostate cancer (all < 0.05). The risk of bone metastasis in patients with prostate cancer increases with increasing Gleason clinical stage and the occurrence of lymph node metastasis. Serum PSA, D-D and CysC have certain diagnostic value in the diagnosis of bone metastasis, and their combination has the highest value.

摘要

目的

本研究旨在分析前列腺癌骨转移的影响因素，以及血清前列腺特异性抗原（PSA）、D-二聚体（D-D）与胱抑素 C（CysC）联合对前列腺癌骨转移的诊断价值。

方法

回顾性分析我院收治的 116 例前列腺癌患者的临床资料，将其分为骨转移组（46 例）和非骨转移组（70 例）。采用单因素和多因素 logistic 回归分析确定前列腺癌骨转移的影响因素。采用受试者工作特征（ROC）曲线分析血清 PSA、D-D 及 CysC 的诊断价值。

结果

116 例患者中，46 例发生骨转移，70 例未发生骨转移。46 例骨转移患者中，8 例（17.39%）为单发骨转移，38 例（82.61%）为多发骨转移。单因素分析结果显示，骨转移与 Gleason 评分升高、临床分期升高、淋巴结转移、全身炎症反应指数升高、纤维蛋白原/白蛋白比值升高、碱性磷酸酶和纤维蛋白原水平升高有关（均 < 0.05）。骨转移组的 Gleason 评分>8 分、临床分期为 T3-T4 期及血清 PSA、D-D、CysC 水平均高于非骨转移组（均 < 0.05）。血清 PSA、D-D、CysC 联合检测对前列腺癌骨转移的诊断价值高于单项指标检测。