血浆FIB、NTx、PSA水平在前列腺癌骨转移诊断中的价值  

Diagnostic value of plasma FIB,NTx,and PSA levels for prostate cancer patients with bone metastasis

作　　者：卢启海[1] 王伟[1] 莫晓东 咸建涛 LU Qihai;WANG Wei;MO Xiaodong;XIAN Jiantao(Urology Surgery,Liuzhou People's Hospital Affiliated to Guangxi Medical University,Liuzhou 545006,China)

机构地区：[1]广西医科大学附属柳州市人民医院泌尿外科,广西柳州545006

出　　处：《山东医药》2022年第10期35-38,共4页Shandong Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210340)。

摘　　要：目的探究血浆纤维蛋白原(FIB)、Ⅰ型胶原氨基末端肽(NTx)及前列腺特异性抗原(PSA)水平在前列腺癌骨转移诊断中的价值。方法选择202例前列腺癌患者,结合影像学检查结果分为骨转移组(70例)和无骨转移组(132例),以55例体检健康男性为健康对照组。采用ELISA法检测血清总PSA、NTx,采用血液凝固法测定FIB。采用单因素及多因素Logistic回归分析影响前列腺癌骨转移的危险因素。采用受试者工作特征(ROC)曲线分析血浆FIB、NTx、PSA及联合检测对前列腺癌骨转移的诊断价值。结果前列腺癌骨转移组血浆FIB、NTx、PSA水平高于无骨转移组(P均<0.05),无骨转移组血浆FIB、NTx、PSA水平高于健康对照组(P均<0.05)。Logistic回归分析结果显示,FIB升高、NTx升高、PSA升高、Gleason评分≥7分及肿瘤分期Ⅲ、Ⅳ期是影响前列腺癌骨转移的独立危险因素(P均<0.05)。血浆FIB、NTx、PSA及联合检测的ROC曲线下面积(AUC)分别为0.628、0.663、0.742及0.815。联合检测诊断前列腺癌骨转移的AUC大于FIB、NTx、PSA单独检测(P均<0.05)。结论血浆FIB、NTx、PSA水平升高与前列腺癌骨转移有关,是前列腺癌骨转移的独立危险因素,三者联合检测对前列腺癌骨转移有较高的诊断价值。Objective To explore the diagnostic value of plasma fibrinogen(FIB),N-telopeptide of typeⅠcolla⁃gen(NTx),and prostate specific antigen(PSA)in bone metastasis of prostate cancer.Methods A total of 202 prostate cancer patients were selected and divided into the bone metastasis group(70 cases),non-bone metastasis group(132 cas⁃es)according to imaging examination,meanwhile,55 cases of healthy men were selected in the healthy control group.En⁃zyme-linked immunosorbent assay(ELISA)was used to detect serum PSA and NTx levels,and blood coagulation method was used to determine FIB.Univariate analysis and multivariate Logistic regression analysis were used to analyze the risk factors of bone metastasis of prostate cancer.Receiver operating characteristic curve was used to analyze the diagnostic val⁃ue of plasma FIB,NTx,PSA and combined detection of them in prostate cancer patients with bone metastasis.Results The plasma FIB,NTx and PSA levels in the bone metastasis group were higher than those in the none-bone metastasis group,and the plasma FIB,NTx and PSA levels in the non-bone metastasis group were higher than those in the healthy control group(all P<0.05).Univariate analysis results showed the elevated FIB,elevated NTx,elevated PSA,Gleason score≥7,and tumor stageⅢ-Ⅳwere all independent risk factors for bone metastasis of prostate cancer.The area under the curve of plasma FIB,NTx,PSA and combined detection of them were 0.628,0.663,0.742,and 0.815,respective⁃ly.The AUC of combined detection for the diagnosis of bone metastasis of prostate cancer was greater than that of FIB,NTx,and PSA alone(all P<0.05).Conclusion The elevated levels of plasma FIB,NTx,and PSA are related to bone metastasis of prostate cancer and are independent risk factors for bone metastasis of prostate cancer;the combined de⁃tection of the three has a high diagnostic value for prostate cancer patients with bone metastasis.

关 键 词：前列腺癌 骨转移 纤维蛋白原 Ⅰ型胶原氨基末端肽 前列腺特异性抗原 诊断价值 

分 类 号：R697.3[医药卫生—泌尿科学]