摘要
目的探索初诊前列腺癌患者骨转移的影响因素及预测因素。方法55例经前列腺穿刺活检术或术后病理初次诊断为前列腺癌患者,根据是否发生骨转移分为伴骨转移组(26例)及不伴骨转移组(29例)。分析初诊前列腺癌患者骨转移的影响因素及预测因素。结果两组患者年龄、外周血淋巴细胞/单核细胞比值(LMR)、血小板计数比较差异无统计学意义(P>0.05);伴骨转移组患者纤维蛋白原降解产物、格里森(Gleason)评分、中性粒细胞/淋巴细胞比值(NLR)分别为(10.28±10.84)mg/L、(8.88±0.65)分、(2.79±1.10),均明显高于不伴骨转移组的(3.42±3.59)mg/L、(8.24±0.99)分、(2.16±0.95),差异具有统计学意义(P<0.05)。将单因素分析中P<0.05的Gleason评分、NLR及纤维蛋白原降解产物纳入Logistic回归模型进行多因素分析,结果显示:Gleason评分、纤维蛋白原降解产物是初诊前列腺癌患者骨转移的危险因素(P<0.05)。利用受试者工作特征(ROC)曲线得出的曲线下面积评估纤维蛋白原降解产物对初诊前列腺癌患者骨转移的预测价值,纤维蛋白原降解产物的曲线下面积为0.774>0.7,提示对初诊前列腺癌患者骨转移有良好的预测价值。纤维蛋白原降解产物的诊断界值为3.2μg/ml,对应的敏感度及特异度分别为0.731、0.724。利用ROC曲线得出的曲线下面积评估Gleason评分对初诊前列腺癌患者骨转移的预测价值,Gleason评分的曲线下面积为0.679,预测价值较低。结论纤维蛋白原降解产物水平对初诊前列腺癌患者骨转移具有良好的预测价值,Gleason评分是初诊前列腺癌患者骨转移的危险因素。
Objective To explore the predictive factors and influencing factors of bone metastasis in newly diagnosed prostate cancer patients.Methods 55 cases were diagnosed as prostate adenocarcinoma by prostate biopsy or postoperative pathology.According to whether bone metastasis orrurred,the newly diagnosed prostate cancer patients were divided into the group with bone metastasis(26 cases)and the group without hone metastasis(29 cases).The influencing factors and predictive factors of hone metastasis in newly diagnosed prostate cancer patients were analyzed.Results There was no statistically significant difference in age,peripheral blood lymphocyte/monocyte ratio(LMR),and platelet count between the two groups(P>0.05).The fibrinogen degradation products,Gleason score and neutrophil-lymphocyte ratio(NLR)of the group with bone metastasis were(10.28±10.84)mg/L and(8.88±0.65)points,and(2.79±1.10),which were significantly higher than(3.42±3.59)mg/L,(8.24±0.99)points and(2.16±0.95)of the group without bone metastasis,and the difference was statistically significant(P<0.05).Gleason score,NLR and fibrinogen degradation product with P<0.05 in univariate analysis were included in Logistic regression model for multifactorial analysis.The results showed that Gleason score and fibrinogen degradation products were risk factors for bone metastasis in newly diagnosed prostate cancer patients(P<0.05).The area under the curve obtained by the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of fibrinogen degradation products for hone metastasis in newly diagnosed prostate cancer patients.The area under the curve of fibrinogen degradation products was 0.774>0.7,suggesting a good predictive value for hone metastasis in newly diagnosed prostate cancer patients.The diagnostic threshold for fibrinogen degradation products was 3.2μg/ml,corresponding to a sensitivity and specificity of 0.731 and 0.724,respectively.The area under the curve obtained by the ROC curve was used to evaluate the predictive val
作者
朱大金
张军
ZHU Da-jin;ZHANG Jun(Department of Urology,Yancheng First People's Hospital,Yancheng 224006,China)
出处
《中国实用医药》
2021年第33期8-11,共4页
China Practical Medicine
关键词
前列腺癌
骨转移
纤维蛋白原降解产物
格里森评分
预测因素
Prostate cancer
Bone metastasis
Fibrinogen degradation products
Gleason score
Predictive factors
