初诊前列腺癌患者治疗前血清唾液酸/总蛋白比值对骨转移的预测价值：列线图模型的建立
Predictive value of the pretreatment serum sialic acid/total protein ratio for bone metastases in newly diagnosed prostate cancer patients: development of a nomogram model.
作者信息
Qiu Laiyuan, Tian Tian, Ma Zhipeng, Sun Jingtao, Zhao Yuxuan, Yang Lin, Ji Yu, Yi Li, Yan Lei, Xu Chuanbing, Li Dawei
机构信息
Department of Urology, Qilu Hospital of Shandong University, Jinan, China.
Cheeloo College of Medicine, Shandong University, Jinan, China.
出版信息
Gland Surg. 2025 Jun 30;14(6):1066-1078. doi: 10.21037/gs-2025-39. Epub 2025 Jun 26.
BACKGROUND
Bone is a common site of distant metastasis, and its metastasis is one of the major causes of death in prostate cancer (PCa) patients. Currently, there is a lack of effective predictive methods. This study aimed to evaluate the potential of pretreatment serum sialic acid/total protein (SA/TP) ratio as a biomarker for predicting PCa and its associated bone metastases.
METHODS
A retrospective analysis was conducted on 641 patients diagnosed with benign prostatic hyperplasia (BPH) or PCa between November 2014 and July 2021. We conducted a comparative analysis of SA/TP levels across various subgroups and investigated the correlation between SA/TP levels and multiple clinical parameters. Independent risk factors were identified through both univariate and multivariate logistic regression analyses, and a predictive model for assessing the risk of bone metastases was developed.
RESULTS
PCa patients presented significantly higher median pretreatment SA/TP levels than BPH patients (P<0.001). Furthermore, within the cohort of PCa patients, individuals with bone metastases demonstrated markedly elevated pretreatment SA/TP levels in contrast to their counterparts without bone metastases (P<0.001). Additionally, receiver operating characteristic (ROC) curve analysis identified an optimal cut-off value of 0.7973 for distinguishing BPH from PCa, accompanied by an area under the curve (AUC) of 0.606 [95% confidence interval (CI): 0.559-0.653, P<0.001]. In parallel, the optimal cut-off value for differentiating between bone metastases and without bone metastases in PCa patients was identified as 0.8560 with an AUC of 0.770 (95% CI: 0.707-0.833, P<0.001). Multivariate logistic regression analysis revealed that a pretreatment SA/TP ≥0.7973 was independently correlated with PCa [hazard ratio (HR) =1.704, 95% CI: 1.016-2.806, P=0.04], whereas a pretreatment SA/TP ≥0.8560 served as an independent risk factor for PCa with bone metastases (HR =2.567, 95% CI: 1.051-6.271, P=0.04).
CONCLUSIONS
The elevated pretreatment SA/TP level is closely associated with the risk of PCa and its subsequent bone metastases.
背景
骨是远处转移的常见部位，其转移是前列腺癌（PCa）患者死亡的主要原因之一。目前，缺乏有效的预测方法。本研究旨在评估治疗前血清唾液酸/总蛋白（SA/TP）比值作为预测PCa及其相关骨转移生物标志物的潜力。
方法
对2014年11月至2021年7月期间诊断为良性前列腺增生（BPH）或PCa的641例患者进行回顾性分析。我们对不同亚组的SA/TP水平进行了比较分析，并研究了SA/TP水平与多个临床参数之间的相关性。通过单因素和多因素逻辑回归分析确定独立危险因素，并建立了评估骨转移风险的预测模型。
结果
PCa患者治疗前SA/TP水平的中位数显著高于BPH患者（P<0.001）。此外，在PCa患者队列中，有骨转移的个体与无骨转移的个体相比，治疗前SA/TP水平明显升高（P<0.001）。此外，受试者工作特征（ROC）曲线分析确定区分BPH与PCa的最佳截断值为0.7973，曲线下面积（AUC）为0.606[95%置信区间（CI）：0.559-0.653，P<0.001]。同时，PCa患者中区分有骨转移和无骨转移的最佳截断值确定为0.8560，AUC为0.770（95%CI：0.707-0.833，P<0.001）。多因素逻辑回归分析显示，治疗前SA/TP≥0.7973与PCa独立相关[风险比（HR）=1.704，95%CI：1.016-2.806，P=0.04]，而治疗前SA/TP≥0.8560是PCa伴骨转移的独立危险因素（HR=2.567，95%CI：1.051-6.271，P=0.04）。
结论
治疗前SA/TP水平升高与PCa及其后续骨转移风险密切相关。
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