前列腺癌骨转移的预测因素  

Predictive factors for bone metastases of prostate cancer

作　　者：陈业辉[1] 聂品[1] 江文[1] 赵仕佳[1] 仉智[1] 林华欣[1] 李淼沅[1] 刘燕青[1] 李鹏麾 朱旭生[2] 

机构地区：[1]广州医科大学附属市一医院泌尿外科,广东广州510180 [2]广州医科大学附属市一医院核医学科,广东广州510180

出　　处：《南方医科大学学报》2016年第2期205-209,共5页Journal of Southern Medical University

基　　金：国家自然科学基金(81273205);广东省自然科学基金(2015A030313731)~~

摘　　要：目的分析前列腺癌骨转移病人多种临床因素与骨转移的相关性,探索前列腺癌病人骨转移的预测因素。方法采用组间对照研究、单因素相关性分析及多因素Logistic回归分析等统计学方法,对45例前列腺癌骨转移病例和同期35例前列腺癌无骨转移病例的年龄、ALP、PSA、ESR、Gleason评分、病理免疫组化中的雄激素受体(AR)表达及ki-67表达进行分析,探索上述指标与前列腺癌骨转移的关系及对骨转移诊断的预测价值。结果在各指标组间对照比较中,骨转移组的各项指标均明显高于非骨转移组,差异有统计学意义(P<0.05)。在单因素相关分析中,年龄、ALP、PSA、ESR、Gleason评分、AR表达及Ki-67表达等与骨转移均有相关性(P<0.05)。在多因素Logistic回归分析中,年龄、ALP、ESR、Ki-67表达等指标不是骨转移的独立相关性因素(P>0.05)。PSA、Gleason评分及AR表达是骨转移的独立性因素,P值分别是0.008、0.013、0.005,OR(95%CI)分别是1.005(1.001,1.009)、5.356(1.431,20.039)、18.594(2.460,140.524)。PSA、Gleason评分及AR表达的cutoff值分别是67.1 ng/m L、7.5、2.5,灵敏度分别是55.6%、75.6%、84.0%,特异度分别是97.1%、82.9%、91.4%。结论血PSA、前列腺癌组织Gleason评分及雄激素受体阳性表达程度是前列腺癌骨转移的预测因素,年龄、ALP、PSA、ESR、ki-67表达等指标并不能准确预测骨转移的发生。Objective To investigate the correlation between a diverse of clinical factors and bone metastases of prostate cancer.Methods The clinical data of 80 patients with prostate cancer were collected and analyzed. The correlations of age, alkaline phosphotase（ALP）, prostate specific antigen（PSA）, erythrocyte sedimentation rate（ESR）, Gleason score, and expressions of androgen receptor（AR） and Ki-67 with bone metastases were analyzed by one-way ANOVA and Logistic regression analysis.The cutoff value, sensitivity and specificity of the independent correlation factors were calculated. Results Forty-five of the 80patients（56%） were found to have bone metastasis, who had significantly older age and higher levels of ALP, PSA, ESR,Gleason score, and expressions of AR and Ki- 67 than those without bone metastasis（P〈0.05）. Logistic regression analysis identified PSA, Gleason score and AR expression as independent factors correlated with bone metastasis with OR（95% CI） of1.005（1.001, 1.009）（P=0.008）, 5.356（1.431, 20.039）（P=0.013）, and 18.594（2.460, 140.524）（P=0.005）, respectively. The cutoff values of PSA, Gleason Score and AR were 67.1 ng/ml, 7.5, and 2.5, respectively; their sensitivities were 55.6%, 75.6%, and 84.0% for predicting bone metastasis with specificities of 97.1%, 82.9%, and 91.4%, respectively. Conclusion Of the factors analyzed, PSA,Gleason score and AR expression, but not age, ALP, PSA, ESR, or Ki-67 expression, are the predictive factors of bone metastasis of prostate cancer.

关 键 词：前列腺癌 骨转移 预测因素 

分 类 号：R737.25[医药卫生—肿瘤]