系统免疫炎症指数对初诊前列腺癌患者骨转移的预测价值  

The predictive value of systemic immune-inflammation index for bone metastasis in patients newly diagnosed with prostate cancer

作　　者：高军 宋伟杰 刘祥虎 黄基崴 张一川[1] 刘建业[1] 汤进[1] 龙智[1] 何乐业[1] Gao Jun;Song Weijie;Liu Xianghu;Huang Jiwei;Zhang Yichuan;Liu Jianye;Tang Jin;Long Zhi;He Leye(Department of Urology,The Third Xiangya Hospital of Central South University,Institute of Prostate Disease of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院泌尿外科,中南大学前列腺疾病研究所,长沙410013

出　　处：《中华泌尿外科杂志》2021年第10期752-757,共6页Chinese Journal of Urology

摘　　要：目的探讨系统性免疫炎症指数(SII)对初诊前列腺癌患者发生骨转移的预测价值。方法回顾性分析2012年6月至2019年7月中南大学湘雅三医院泌尿外科收治的308例前列腺癌患者的临床病理资料。中位年龄71(65~76)岁。直肠指检(DRE)阳性59例(19.2%)。中位血清总前列腺特异性抗原(tPSA)为60.55(23.55~100.00)ng/ml。中位前列腺体积(PV)39.35(28.29~56.66)ml。中位PSA密度(PSAD)1.27(0.58~2.52)ng/(ml·cm^(3))。穿刺Gleason评分≤6分33例(10.7%),7分115例(37.3%),≥8分160例(52.0%)。临床分期T_(1)期21例(6.8%),T_(2)期87例(28.2%),T_(3)期65例(21.1%),T_(4)期135例(43.9%)。SII=中性粒细胞计数×血小板计数/淋巴细胞计数。中位SII为458.60(300.42~727.11)/L。根据全身骨扫描结果将患者分为两组,比较两组间一般临床病理指标的差异。采用单因素分析筛选出骨转移的相关因素,通过多因素logistic回归分析筛选影响骨转移的独立危险因素。采用受试者工作特征(ROC)曲线比较各独立危险因素对初诊前列腺癌患者发生骨转移的预测价值。结果骨转移组146例(47.4%),无骨转移组162例(52.6%)。骨转移组中位SII为564.78(333.85~961.93)/L,明显高于无骨转移组413.01(267.63~601.79)/L,差异有统计学意义(P<0.001)。骨转移组和无骨转移组的tPSA分别为97.79(48.20~119.10)ng/ml和32.56(17.89~72.70)ng/ml,PSAD分别为1.91(0.97~3.55)ng/(ml·cm^(3))和0.90(0.45~1.77)ng/(ml·cm^(3)),差异有统计学意义(P<0.001);DRE阳性分别为132例(90.4%)和117例(72.2%),差异有统计学意义(P<0.001);穿刺Gleason评分≤6分、7分、≥8分分别为7例(4.8%)和26例(16.1%),50例(34.2%)和65例(40.1%),89例(61.0%)和71例(43.8%),差异均有统计学意义(P<0.001);T_(1)、T_(2)、T_(3)、T_(4)期分别为2例(1.4%)和19例(11.7%),19例(13.0%)和68例(42.0%),25例(17.1%)和40例(24.7%),100例(68.5%)和35例(21.6%),差异均有统计学意义(P<0.001)。两组的年龄(P=0.057)和PV(P=0.222)差异无统计学意义。单�Objective To explore the predictive value of the systemic immune inflammation index(SII)for the risk of bone metastases in patients with newly diagnosed prostate cancer(PCa).Methods From Jun.2012 to Jul.2019,the clinical features of 308 patients were retrospectively analyzed.For the baseline clinical data of the patients with newly diagnosed PCa,the median age was 71(65-76)years,there were 59(19.2%)patients with a positive digital rectal examination(DRE).In addition,the median serum total prostate-specific antigen(tPSA),prostate volume(PV)and prostate-specific antigen density(PSAD)were 60.55(23.55-100.00)ng/ml,39.35(28.29-56.66)ml and 1.27(0.58-2.52)ng/(ml·cm^(3)),respectively.There were 33(10.7%)patients with prostate biopsy Gleason score≤6,115(37.3%)patients with a Gleason score=7 and 160(52.0%)patients with a Gleason score≥8.The T clinical stage also obtained,including 21(6.8%)diagnosed as T_(1) stage,87(28.2%)T_(2) stage,65(21.1%)T_(3)stage,135(43.9%)T_(4) stage.SII was calculated by the formula platelet×neutrophil/lymphocyte,and the median(interquartile range)of SII was 458.60(300.42-727.11)/L.According to the results of bone scanning,the patients were divided into bone metastasis(146,47.4%)and a non-bone metastasis groups(162,52.6%).The differences in the baseline clinical characteristics between the two groups were analyzed.The risk factors of bone metastasis were analyzed by univariate and multivariate logistic regression analysis.The diagnostic efficiency of the risk factors were evaluated by receiver operating characteristic(ROC)curve.Results The median(interquartile range)of SII was 564.78/L(333.85-961.93/L)in patients with bone metastasis which were higher than those without bone metastasis 413.01(267.63-601.79)/L(P<0.001).The median(interquartile range)of tPSA were 97.79(48.20-119.10)ng/ml in bone metastasis group and 32.56(17.89-72.70)ng/ml in non-bone metastasis group(P<0.001).The median(interquartile range)of PSAD were 1.91(0.97-3.55)ng/(ml·cm^(3))and 0.90(0.45-1.77)ng/(ml·cm^(3))in these

关 键 词：前列腺肿瘤 系统免疫炎症指数 肿瘤转移 预测 

分 类 号：R737.25[医药卫生—肿瘤]