摘要
目的探讨血清PSA、IL-6和IL-10水平对前列腺癌的诊断价值。方法收集首诊于泌尿外科并行前列腺穿刺活组织检查(活检)的143例患者临床资料,按其活检结果分为前列腺癌组84例、非前列腺癌组59例。比较2组患者的年龄、身高、体质量、BMI、全血细胞计数(CBC)以及血清总PSA(tPSA)、游离PSA(fPSA)、IL-6和IL-10水平间的差异。以病理结果为因变量,运用单因素logistic回归筛选出有统计学意义的指标,进一步纳入多因素二元logistic回归方程,建立最终的诊断模型。运用受试者工作特征(ROC)曲线比较多指标联合与单项指标在前列腺癌中的诊断价值。结果前列腺癌组患者的年龄、单核细胞绝对值以及血清tPSA、IL-6和IL-10水平均高于非前列腺癌组患者,而淋巴/单核比值(LMR)、f/tPSA均低于非前列腺癌组(P均<0.05)。Spearman秩相关分析显示IL-6与IL-10呈正相关(r_(s)=0.602,P<0.01),年龄和tPSA之间呈弱相关(r_(s)=0.243,P=0.003),logistic回归分析显示年龄、血清tPSA和IL-6水平是前列腺癌的影响因素,建立回归模型logit P=-7.811+0.098X_(年龄)+0.040X_(tPSA)+0.092X_(IL-6)。联合检测得到的新诊断变量曲线下面积达到0.832,当截断值为0.584时,灵敏度为71.4%、特异度为84.7%,均高于各单项指标(P均<0.05)。结论血清IL-6和IL-10水平检测在前列腺癌诊断中具有一定的临床价值,年龄和血清tPSA、IL-6水平是诊断前列腺癌的有效指标,三者联合检测可提高诊断效能。
Objective To explore the diagnostic value of serum prostate-specific antigen(PSA),interleukin-6(IL-6)and interleukin-10(IL-10)levels in prostate cancer by logistic regression and receiver operating characteristic(ROC)curve.Methods A total of 143 patients who first underwent prostate biospy in Department of Urology were selected and divided into the prostate cancer group(PCa)(n=84)and non-prostate cancer group(non-PCa)(n=59).The differences in age,height,weight,body mass index(BMI),complete blood cell count(CBC),serum levels of total(tPSA)and free PSA(fPSA),IL-6 and IL-10 were compared between two groups.Taking the pathological results as an dependent variable,and the multi-factor binary logistic regression equation was further incorporated to establish the final predictive model.The ROC curve was used to compare the predictive value of multiple indicators combined and single indicator in the new model for the diagnosis of prostate cancer.Results The mean age,absolute number of monocyte(M),tPSA,IL-6 and IL-10 levels in the PCa group were significantly higher than those in the non-PCa group(all P<0.05),while the mean lymphoid/monocyte ratio(LMR)and f/tPSA were significantly lower than those in the non-PCa group(both P<0.05).Spearman rank correlation test showed that there was a significant positive correlation between IL-6 and IL-10(r_(s)=0.602,P<0.01),and a weak correlation between age and tPSA(r_(s)=0.243,P=0.003).The results of logistic regression analysis demonstrated that age,tPSA and IL-6 were laboratory indicators that could independently diagnose malignant prostate tumors.A regression model was established:logit P=-7.811+0.098X_(Age)+0.040X_(tPSA)+0.092X_(IL-6).The area under the ROC curve(AUC)of the new diagnosis variable obtained by combined detection reached 0.832.When the cut-off value was 0.584,the sensitivity was 71.4%and the specificity was 84.7%,both higher than those of the individual indicator alone(both P<0.05).Conclusions IL-6 and IL-10 levels have certain clinical value in the diagnosis of pros
作者
陈颖聪
吴婧蔚
严赟
陈娅娅
陈铁定
李如兵
王峰
Chen Yingcong;Wu Jingwei;Yan Yun;Chen Yaya;Chen Tieding;Li Rubing;Wang Feng(Medical School of Ningbo University,Ningbo 315211,China)
出处
《新医学》
CAS
2022年第2期123-128,共6页
Journal of New Medicine
基金
宁波市科技计划项目(202003N4258)。
