中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (11): 1025-1028.doi: 10.12007/j.issn.0258-4646.2018.11.015

• 论著 • 上一篇    下一篇

前列腺癌骨转移的预测因素分析

汪鑫, 蔡凯, 王梁, 戴志红, 万胡强, 卢相甫, 刘志宇   

  1. 大连医科大学附属第二医院泌尿外科, 辽宁 大连 116023
  • 收稿日期:2017-09-18 出版日期:2018-11-30 发布日期:2018-12-06
  • 通讯作者: 刘志宇 E-mail:lzydoct@163.com
  • 作者简介:汪鑫(1992-),男,硕士研究生.

Analysis of Predictors of Bone Metastasis in Prostate Cancer

WANG Xin, CAI Kai, WANG Liang, DAI Zhihong, WAN Huqiang, LU Xiangfu, LIU Zhiyu   

  1. Department of Urology, The Second Affiliated Hospital, Dalian Medical University, Dalian 116023, China
  • Received:2017-09-18 Online:2018-11-30 Published:2018-12-06

摘要: 目的 探讨前列腺癌骨转移的预测因素。方法 回顾性分析2013年1月至2017年7月于我院经前列腺穿刺活检确诊的314例前列腺癌患者的临床资料。根据全身骨扫描结果,将患者分为骨转移组和非骨转移组,采用组间对照研究、单因素相关性分析及多因素回归分析等统计学方法对前列腺癌骨转移相关因素进行分析。运用受试者工作特征曲线(ROC曲线)比较前列腺特异性抗原(PSA)、PSA密度(PSAD)及碱性磷酸酶(ALP)对骨转移的诊断价值。结果 单因素分析结果显示,Gleason评分、临床T分期、PSA、PSAD及ALP与骨转移均有相关性(P<0.001);多因素回归分析结果显示,PSA、临床T分期及ALP是骨转移的独立性预测因素(P<0.05)。PSA、PSAD及ALP的cutoff值分别为48.3 ng/mL、0.9 ng/(mL·cm3)和91.0 U/L,敏感性分别是81.2%、80.5%和61.7%,特异性分别为77.9%、72.4%和88.3%。结论 PSA、临床T分期及ALP是前列腺癌骨转移的预测因素,PSA>48.3 ng/mL、PSAD>0.9 ng/(mL·cm3)或ALP>91.0 U/L时,建议进行全身骨扫描检查,有助于早期发现骨转移并及时治疗。

关键词: 前列腺癌, 骨转移, 核素骨显像

Abstract: Objective To analyze the correlation between diverse clinical factors and bone metastases of prostate cancer. Methods The clinical data of 314 cases with prostate cancer between January 2013 and July 2017 were retrospectively analyzed. These patients were divided into control and experimental groups. Univariate and multivariate logistic regression analyses were conducted on prostate cancer bone metastasis-related factors. The cutoff value,sensitivity,and specificity of the independent correlation factors were calculated. Results Single-factor analysis revealed that clinical T stage,Gleason score,prostate specific antigen (PSA) level,PSA density (PSAD),and alkaline phosphatase (ALP) level correlated with bone metastasis (P<0.001). The logistic regression analysis revealed that clinical T stage,PSA level,and ALP level were independent factors of bone metastasis (P<0.05). The cutoff PSA level,PSAD,and ALP level were respectively 48.3 ng/mL,0.9 ng/(mL·cm3),and 91.0 U/L,with sensitivities of 81.2%,80.5%,and 61.7%,and specificities of 77.9%,72.4%,and 88.3%,respectively. Conclusion PSA level,clinical T stage,and ALP level are the predictors of bone metastasis of prostate cancer. When PSA >48.3 ng/mL,PSADs >0.9 ng/(mL·cm3),and ALP >91.0 U/L,we suggest that whole-body bone scan is helpful in the early diagnosis of bone metastasis and timely treatment.

Key words: prostate cancer, bone metastasis, radionuclide bone imaging

中图分类号: 

  • R737.25
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