前列腺癌骨转移相关危险因素分析及预测模型的建立
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  • 英文篇名:Analysis of risk factors related to bone metastasis of prostate cancer and establishment of a prediction model
  • 作者:陈博 ; 杜雪梅 ; 冯伟 ; 彭婉舒
  • 英文作者:CHEN Bo;DU Xuemei;FENG Wei;PENG Wanshu;Department of Nuclear Medicine, the First Affiliated Hospital of Dalian Medical University;
  • 关键词:前列腺癌 ; 骨转移 ; tPSA ; Gleason评分
  • 英文关键词:prostate cancer;;bone metastasis;;tPSA;;Gleason Score
  • 中文刊名:DLYK
  • 英文刊名:Journal of Dalian Medical University
  • 机构:大连医科大学附属第一医院核医学科;
  • 出版日期:2019-02-20
  • 出版单位:大连医科大学学报
  • 年:2019
  • 期:v.41
  • 语种:中文;
  • 页:DLYK201901012
  • 页数:5
  • CN:01
  • ISSN:21-1369/R
  • 分类号:43-46+69
摘要
目的探讨年龄、血尿、血清碱性磷酸酶(ALP)、tPSA及Gleason评分(Gleason Score,GS)在诊断前列腺癌骨转移中的价值。方法回顾性分析经病理学证实的277例前列腺癌患者,均于治疗前1周内行SPECT全身骨显像及血清学检测,其中无骨转移组149例,骨转移组128例。分析两组间年龄、血尿与否、ALP、tPSA及总GS、主要部分GS、次要部分GS的差异,进一步多因素Logistic回归分析骨转移的危险因素并建立基于相关危险因素预测前列腺癌骨转移的数学模型,ROC曲线比较其诊断的准确性。结果除年龄外(P=0.736),ALP、血尿与否、tPSA、总GS、主要部分GS、次要部分GS组间差异均具有明显统计学意义(均P<0.01)。多因素Logistic回归分析仅ALP、tPSA、主要部分GS纳入回归方程,基于ALP、tPSA、主要部分GS预测前列腺癌骨转移的数学模型为:P=e~y/(1+e~y),y=-8.317+0.035×ALP+0.020×tPSA+0.912×主要部分GS。ALP、tPSA、主要部分GS及数学模型的ROC曲线AUC分别为0.804、0.808、0.712、0.906。结论 ALP、tPSA及主要部分GS是前列腺癌骨转移的独立危险因素,基于上述3种因素建立的数学模型对前列腺癌骨转移的预测作用更佳。
        Objective To investigate the relationship between age, presence of blood in urine, tPSA, and total Gleason Score(GS) with bone metastasis of prostate cancer. Methods Clinical data of 277 patients with prostate cancer confirmed by pathology were retrospective analyzed. The patients underwent SPECT bone imaging and blood testing before treatment. Among them, 128 patients had bone metastasis and 149 patients did not. The differences of age, ALP, presence of blood urine, tPSA, total GS, primary GS, and secondary GS between the two groups were analyzed. The prognostic factors of bone metastasis were analyzed to obtain a mathematical model by Logistic regression analysis. The diagnostic efficiency of the mathematical model was evaluated by ROC curve. Results Except of age(P=0.736), there were significant differences in ALP, presence of blood in urine, tPSA, total GS, primary GS, and secondary GS between the two groups(P<0.01). Logistic regression analysis identified ALP, tPSA and primary GS as independent factors related to bone metastasis. The mathematical model based on ALP, tPSA and primary GS of prostate cancer patients in SPECT bone imaging was stated by P= e~y/(1+ e~y),y=-8.317+0.035×ALP+0.020×tPSA+0.912×primary GS. The AUC of ALP, tPSA, primary GS and mathematical model were 0.804, 0.808, 0.712 and 0.906, respectively. Conclusion ALP, tPSA and primary GS are the independent factors related to bone metastasis of prostate cancer. The mathematical model based on ALP, tPSA and primary GS of prostate cancer patients in SPECT bone imaging have high potential predicting bone metastasis.
引文
[1] 洪钟亮,毛云峰,徐倩.前列腺癌发生骨转移的研究概况[J].中国临床药理学杂志,2014,30(1):58-60.
    [2] Hensel J,Thalmann GN.Biology of Bone Metastases in prostate cancer[J].Urology,2016,92:6-13.
    [3] 刘攀,姜睿.前列腺癌骨病诊断和治疗进展[J].临床泌尿外科杂志, 2016,31(8):762-766.
    [4] Epstein JI,Amin MB,Reuter VE,et al. Contemporary Gleason Grading of Prostatic Carcinoma: An Update With Discussion on Practical Issues to Implement the 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma[J]. Am J Surg Pathol,2017,41(4):e1-e7.
    [5] 李红,周昕,付鹏.血清降序磷酸酶动态检测在恶性肿瘤骨转移的临床价值[J].医学信息,2014,3(28):113-115.
    [6] 梁树君,朱广文,周绍军.SPECT骨显像联合血清碱性磷酸酶检测评估肺癌患者骨转移负荷的价值[J].现代肿瘤医学,2017,25(13):2140-2143.
    [7] Metwalli AR,Rosner IL,Cullen J,et al.Elevated alkaline phosphatase velocity strongly predicts overall survival and the risk of bone metastases in castrate-resistant prostate cancer[J].Urol Oncol,2014,32(6):761-768.
    [8] Wellington K,Goa KL.Zoledronic acid:a review of its use in the management of bone metastases and hypercalcaemia of malignancy[J].Drugs,2003,63(4):417-437.
    [9] 陈亚辉,聂品,江文,等.前列腺癌骨转移的预测因素[J].南方医科大学学报,2016,36(2):205-209.
    [10] 谢龙,何玲玲,黄丽,等.核素骨显像联合血清前列腺特异性抗原、免疫组化及Gleason评分系统在前列腺癌骨转移诊断中的应用[J].福建医药杂志,2018,40(1):71-73.
    [11] 张鸿毅,高继学,张培波,等.晚期前列腺癌多发转移风险预测指标的探讨[J].现代肿瘤医学,2017,(11):1743-1746.
    [12] 曹仲年,耿建华,郑容,等.前列腺癌患者全身骨显像骨转移因素分析[J].中国医学装备,2018,15(9):79-82.
    [13] Pir?a M, Pezelj I, Kne?evi,et al.Incidental Prostate Cancer in Patients Treated for Benign Prostate Hyperplasia in the Period of 21 Years[J]. Acta Clin Croat,2018,57(1):71-76.
    [14] Avery HJ,Droller MJ.Do Gleason patterns 3 and 4 prostate cancer represent separate disease state[J].J Urol,2012,188(5):1667-1675.
    [15] 钟明艳.前列腺癌根治术后患者Gleason评分3+4和4+3的临床资料分析[D].福建医科大学,2013.
    [16] Alenda O,Ploussard G,Mouraxade P,et al.Impact of the primary Gleason pattern on biochemical recurrence free survial after radical prostatectomy:a single-center of 1248 patients with Gleason 7 tumor[J].World J Urol,2011,29(5):671-676.
    [17] Whittemore DE,Hick EJ,Carter MR,et al.Significance of tertiary Gleason pattern 5 in Gleason score 7 radical prostatectomy specimens[J].J Urol,2008,179(2):516-522.
    [18] Berg KD,Roder MA,Brasso K,et al.Primary Gleason pattern in biopsy Gleason score 7 is predictive of adverse histopathological features and biochemical failure following radical prostatectomy[J].Scand J Urol,2014,48(2):168-176.
    [19] Koh WJ,Greer BE,Abu-Rustum NR,et al. Uterine Sarcoma, Version 1.2016 Featured Updates to the NCCN Guidelines[J]. J Natl Compr Canc Netw,2015,13(11):1321-1331.
    [20] 陈亚辉,聂品,江文.前列腺癌骨转移的预测因素[J].南方医科大学学报,2016,36(2):205-209.
    [21] 林军明,刘家明,周扬,等.前列腺癌骨转移的特点及其相关危险因素分析[J].解放军医学杂志,2017,42(8):707-711.
    [22] 张海洋,金讯波. 前列腺癌的诊断[J].泌尿外科杂志(电子版) ,2013,5(3):49-54.

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