前列腺癌骨转移相关危险因素分析及预测模型的建立
Analysis of risk factors related to bone metastasis of prostate cancer and establishment of a prediction model
投稿时间:2018-08-29  
DOI:10.11724/jdmu.2019.01.08
中文关键词:  前列腺癌  骨转移  tPSA  Gleason评分
英文关键词:prostate cancer  bone metastasis  tPSA  Gleason Score
基金项目:
作者单位
陈 博 大连医科大学附属第一医院 核医学科辽宁 大连 116011 
杜雪梅 大连医科大学附属第一医院 核医学科辽宁 大连 116012 
冯 伟 大连医科大学附属第一医院 核医学科辽宁 大连 116013 
彭婉舒 大连医科大学附属第一医院 核医学科辽宁 大连 116014 
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中文摘要:
      目的 探讨年龄、血尿、血清碱性磷酸酶(ALP)、tPSA及Gleason评分(Gleason Score,GS)在诊断前列腺癌骨转移中的价值。 方法 回顾性分析经病理学证实的277例前列腺癌患者,均于治疗前1周内行SPECT全身骨显像及血清学检测,其中无骨转移组149例,骨转移组128例。分析两组间年龄、血尿与否、ALP、tPSA及总GS、主要部分GS、次要部分GS的差异,进一步多因素Logistic回归分析骨转移的危险因素并建立基于相关危险因素预测前列腺癌骨转移的数学模型,ROC曲线比较其诊断的准确性。 结果 除年龄外(P=0.736),ALP、血尿与否、tPSA、总GS、主要部分GS、次要部分GS组间差异均具有明显统计学意义(均P<0.01)。多因素Logistic回归分析仅ALP、tPSA、主要部分GS纳入回归方程,基于ALP、tPSA、主要部分GS预测前列腺癌骨转移的数学模型为:P=ey/(1+ey),y=-8.317+0.035×ALP+0.020×tPSA+0.912×主要部分GS。ALP、tPSA、主要部分GS及数学模型的ROC曲线AUC分别为0.804、0.808、0.712、0.906。 结论 ALP、tPSA及主要部分GS是前列腺癌骨转移的独立危险因素,基于上述3种因素建立的数学模型对前列腺癌骨转移的预测作用更佳。
英文摘要:
      Objective To investigate the relationship between age, presence of blood in urine, tPSA, and total Gleason Score (GS) with bone metastasis of prostate cancer. Methods Clinical data of 277 patients with prostate cancer confirmed by pathology were retrospective analyzed. The patients underwent SPECT bone imaging and blood testing before treatment. Among them, 128 patients had bone metastasis and 149 patients did not. The differences of age, ALP, presence of blood urine, tPSA, total GS, primary GS, and secondary GS between the two groups were analyzed. The prognostic factors of bone metastasis were analyzed to obtain a mathematical model by Logistic regression analysis. The diagnostic efficiency of the mathematical model was evaluated by ROC curve. Results Except of age (P=0.736), there were significant differences in ALP, presence of blood in urine, tPSA, total GS, primary GS, and secondary GS between the two groups (P<0.01). Logistic regression analysis identified ALP, tPSA and primary GS as independent factors related to bone metastasis. The mathematical model based on ALP, tPSA and primary GS of prostate cancer patients in SPECT bone imaging was stated by P= ey/(1+ ey),y=-8.317+0.035×ALP+0.020×tPSA+0.912×primary GS. The AUC of ALP, tPSA , primary GS and mathematical model were 0.804, 0.808, 0.712 and 0.906, respectively. Conclusion ALP, tPSA and primary GS are the independent factors related to bone metastasis of prostate cancer. The mathematical model based on ALP, tPSA and primary GS of prostate cancer patients in SPECT bone imaging have high potential predicting bone metastasis.
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