前列腺特异性抗原动态分析对阿比特龙治疗的去势抵抗性前列腺癌患者预后的预测价值  

Predictive value of prostate-specific antigen variables on prognosis in castration-resistant prostate cancer patients treated with abiraterone

作　　者：钱友良[1] 陈智彬 黄朝友[1] 赖飞[1] 杨振[1] 李娇 QIAN You-liang;CHEN Zhi-bin;HUANG Chao-you;LAI Fei;YANG Zhen;LI Jiao(Department of Urology,Chengdu Second People’s Hospital,Chengdu 610017,Sichuan Province,China)

机构地区：[1]成都市第二人民医院泌尿外科,四川成都610017

出　　处：《中国临床药理学杂志》2020年第18期2778-2781,共4页The Chinese Journal of Clinical Pharmacology

基　　金：四川省医学科研青年创新课题计划基金资助项目(Q16045)。

摘　　要：目的探讨前列腺特异性抗原(PSA)水平变化对预测阿比特龙治疗后的去势抵抗性前列腺癌(CRPC)患者1年内预后的诊断价值。方法将64例CRPC患者作研究对象,根据随访1年内死亡情况分为对照组和试验组。比较2组入组、随访4周、随访8周时的血清PSA水平及其与入组时的差值(ΔPSA1、ΔPSA2)。另根据ΔPSA1、ΔPSA2与入组时PSA比值是否≥50%分为高、低ΔPSA1组及高、低ΔPSA2组。对患者随访1年中死亡相关因素进行单因素分析,以Kaplan-Meier法进行生存分析,用COX回归分析死亡相关因素,绘制ROC曲线分析不同指标对患者1年内死亡情况的预测效能。结果最终纳入60例,24例死亡(40.00%)。对照组Gleason评分低于试验组(P<0.05),对照组骨转移例数、ΔPSA1、ΔPSA2高于试验组(均P<0.05);Gleason评分(P<0.05)为CRPC患者1年内死亡的危险因素,ΔPSA1(HR=0.768,P<0.05)和ΔPSA2(P<0.05)为CRPC患者1年内死亡的保护因素;诊断敏感性分别为62.50%,83.34%,70.82%,三者AUC差异无统计学意义(P>0.05)。结论 PSA水平变化与接受阿比特龙治疗的CRPC患者1年内死亡情况有显著相关性,监测患者PSA水平动态具有一定预测意义。Objective To explore the diagnostic efficiency of prostate specific antigen(PSA) variables for predicting prognosis within one year in castration-resistant prostate cancer(CRPC)patients treated with abiraterone. Methods A total of 64 CRPC patients were divided into treatment group and control group depending on death situation in a year of follow-up.The serum PSA level at baseline,4 th week and 8 th week of follow-up,the difference value between the latter two and baseline PSA(ΔPSA1,ΔPSA2)were recorded.In addition,patients were divided into high and low ΔPSA1 groups, high and low ΔPSA2 groups by whether ΔPSA1 and ΔPSA2-baseline PSA radio≥50%.Univariate analysis was performed on related factors of CRPC patients death within a year, Kaplan-Meier method was used to perform survival analysis.COX regression was used to analyse the related factors of death within one year, constructing ROC curve to assess prediction efficiency of different indicators on patients’ death situation within a year.Results There were 60 cases were employed,including 24 death cases(40.00%).Gleason score in control group was lower than that in treatment group( P < 0. 05),bone metastasis cases,ΔPSA1,ΔPSA2 in control group were higher than those in treatment group( all P < 0. 05);Gleason score( P < 0. 05) was the risk factors of CRPC patients’ death within a year,ΔPSA1( P < 0. 05) and ΔPSA2( P < 0. 05) were the protective factors of CRPC patients’ death within a year,the sensitivity were 62. 50%,83. 34%,70. 82% respectively,there was no significant difference among them in AUC( P > 0. 05). Conclusion PSA variables was significantly related to death situation in a year in CRPC patients treated with abiraterone,detecting patients’ PSA variables has certain meaning for predicting prognosis.

关 键 词：前列腺特异性抗原 去势抵抗性前列腺癌 阿比特龙 诊断价值 

分 类 号：R979.1[医药卫生—药品]