前列腺健康指数、PSAD和血清GPC-3对行前列腺癌根治术患者预后的预测价值  

Predictive value of prostate health index,PSAD,and serum GPC-3 for the prognosis of patients undergoing radical prostatectomy for prostate cancer

作　　者：张丽 杜波 杜凌云 ZHANG Li;DU Bo;DU Ling-yun(Department of Laboratory,Yulin Traditional Chinese Medicine Hospital,Yulin Shaanxi 719000,China;Department of Urology,Yulin Traditional Chinese Medicine Hospital,Yulin Shaanxi 719000,China)

机构地区：[1]榆林市中医医院检验科,陕西榆林719000 [2]榆林市中医医院泌尿外科,陕西榆林719000

出　　处：《临床和实验医学杂志》2024年第22期2401-2404,共4页Journal of Clinical and Experimental Medicine

基　　金：陕西省中医药管理局科研项目(编号:SZY-NLTL-2022-041)。

摘　　要：目的研究前列腺健康指数(PHI)、前列腺特异性抗原密度(PSAD)和血清磷脂酰肌醇蛋白聚糖-3(GPC-3)对行前列腺癌根治术患者预后的预测价值。方法回顾性纳入2018年5月至2021年6月在榆林市中医医院接受前列腺癌根治术的80例患者作为研究对象,根据患者术后3年是否发生前列腺癌相关死亡或复发将其分为预后不良组(n=21)和预后良好组(n=59)。比较前列腺癌患者手术前和手术后1周的PHI、PASD和血清GPC-3水平,收集预后不良组和预后良好组的一般临床资料(年龄、体重、身高、肿瘤分期、肿瘤直径、前列腺体积、病理类型、Gleason评分、术切除组织边缘肿瘤细胞染色结果及肿瘤分化程度等),并通过多因素Logistics回归分析确定影响前列腺癌根治术后预后不良的影响因素。通过受试者操作特征(ROC)曲线评估各影响因素对前列腺癌根治术后预后不良的预测价值。结果前列腺癌患者术后的PHI、PASD和血清GPC-3分别为32.61±9.42、0.58±0.18、(15.62±5.37)μg/L,均显著低于术前[41.23±10.56、0.65±0.24、(26.95±5.71)μg/L],差异均有统计学意义(P<0.05)。单因素和多因素Logistics回归分析显示,TNM分期高、切缘阳性、肿瘤低分化、术后PHI高、术后PSAD高以及术后GPC-3高是前列腺癌根治术后预后不良的独立危险因素(P<0.05)。ROC曲线分析显示:术后PHI、术后PSAD和术后GPC-3预测前列腺癌根治术后预后不良的曲线下面积分别为0.803、0.730和0.847,最佳横截面值分别为28.50、16.50和0.575μg/L。结论前列腺癌根治术后高PHI、高PSAD和高血清GPC-3是前列腺癌患者术后预后不良的独立危险因素,三者对前列腺根治术后预后不良均较高的预测价值。Objective To investigate the predictive value of prostate health index(PHI),prostate specific antigen density(PSAD)and serum phosphatidylinositol proteoglycan-3(GPC-3)on prognosis of prostatectomy in prostate cancer patients.Methods A total of 80 patients who underwent radical prostatectomy in Yulin Hospital of Traditional Chinese Medicine from May 2018 to June 2021 were retrospectively included in the study,and the patients were divided into the poor prognosis group(n=21)and the good prognosis group(n=59)according to whether they had prostate cancer-related death or recurrence 3 years after surgery.The levels of PHI,PASD and serum GPC-3 in patients with prostate cancer before and 1 week after operation were compared.The general clinical data(age,weight,height,tumor stage,tumor diameter,prostate volume,pathological type,Gleason score,staining results of tumor cells at the edge of resected tissue and degree of tumor differentiation)were compared between the the poor prognosis group and the good prognosis group.The influencing factors of poor prognosis after radical prostatectomy were determined by multivariate Logistics regression analysis.The predictive value of each influencing factor on the poor prognosis after radical prostatectomy was evaluated using the receiver operating characteristic(ROC)curve.Results The PHI,PASD and serum GPC-3 in patients with prostate cancer after operation were 32.61±9.42,0.58±0.18 and(15.62±5.37)μg/L,respectively,which were significantly lower than those before operation[41.23±10.56,0.65±0.24 and(26.95±5.71)μg/L],and the differences were statistically significant(P<0.05).Univariate and multivariate logistics regression analysis showed that high TNM stage,positive resection margins,low tumor differentiation,high postoperative PHI,high postoperative PSAD,and high postoperative GPC-3 were independent risk factors for poor prognosis of prostate cancer in patients with prostate cancer after radical prostatectomy(P<0.05).Conclusion High postoperative PHI,high postoperative PSAD,an

关 键 词：前列腺癌 前列腺健康指数 前列腺特异性抗原密度 磷脂酰肌醇蛋白聚糖-3 预后不良 

分 类 号：R737.25[医药卫生—肿瘤]