摘要
目的探讨骨标志物和前列腺特异性抗原(PSA)对前列腺癌发展为去势抵抗性前列腺癌(CRPC)的预测价值。方法以该院收治的114例前列腺癌患者为研究对象,所有患者均于入组时检测血清PSA、碱性磷酸酶(ALP)及Ⅰ型胶原交联羧基末端肽(ⅠCTP)水平。随访2年,根据患者是否发生CRPC分为CRPC组和无CRPC组,比较两组一般情况及血清PSA、ALP、ⅠCTP水平,对单因素分析差异有统计学意义的指标进一步进行多因素Logistic回归分析。采用Pearson相关分析法分析患者PSA、ALP、ⅠCTP水平与Gleason、mGPS评分相关性。采用受试者工作特征(ROC)曲线分析PSA、ALP、ⅠCTP水平预测CRPC的临床价值。结果与无CRPC组比较,CRPC组血清PSA、ALP、ⅠCTP水平更高,差异有统计学意义(P<0.05),多因素Logistic回归分析结果显示,淋巴结转移(N2~N3)、肿瘤浸润深度(T3~T4)、有骨转移、mGPS评分≥1分、Gleason评分≥8分、PSA≥50.30μg/L、ALP≥69.45 U/L及ⅠCTP≥6.48μg/L是发生CRPC的独立危险因素。相关分析显示,PSA、ALP、ⅠCTP水平与Gleason、mGPS评分均呈正相关(P<0.05)。ROC曲线分析结果显示,PSA、ALP、ⅠCTP联合检测在预测CRPC中的AUC为0.944。结论CRPC患者PSA、ALP、ⅠCTP水平明显升高,且3项指标联合检测预测前列腺癌发展为CRPC具有较高的临床价值。
Objective To explore the predictive value of bone markers and prostate specific antigen(PSA)in the development of castration-resistant prostate cancer(CRPC)in prostate cancer.Methods A total of 114 cases of prostate cancer admitted to the First Affiliated Hospital of Hebei North University were selected as the research objects.All patients were tested for serum PSA,alkaline phosphatase(ALP)and typeⅠcollagen cross-linked carboxy-terminal peptide(ⅠCTP)level at the time of enrollment.Followed up for 2 years,the patients were divided into CRPC group and non-CRPC group according to whether or not CRPC occurred.The general information and serum PSA,ALP,andⅠCTP levels in the two groups were compared.The factors with statistical differences were further analyzed by Logistic regression.The Pearson correlation method was used to analyze the correlations between PSA,ALP,ⅠCTP levels in patients and Gleason,mGPS score.The Receiver Operating Characteristic(ROC)curve was used to analyze the clinical value of PSA,ALP andⅠCTP levels in predicting CRPC.Results Compared with those in non-CRPC group,the serum PSA,ALP,andⅠCTP levels in CRPC group were higher(P<0.05).The multivariate Logistic regression analysis showed that lymph node metastasis(N2-N3),tumor invasion depth(T3-T4),bone metastasis,mGPS score≥1,Gleason score≥8,PSA≥50.30μg/L,ALP≥69.45 U/L,ⅠCTP≥6.48μg/L were independent risk factors for CRPC.Correlation analysis showed that the levels of PSA,ALP andⅠCTP correlated positively with Gleason score and mGPS score(P<0.05).ROC curve results showed that the AUC of combined detection of PSA,ALP,ⅠCTP was 0.944.Conclusion The levels of PSA,ALP andⅠCTP in CRPC patients increase significantly,and the combined detection of the three indicators has high clinical value in predicting the occurrence of CRPC.
作者
温雪丽
WEN Xueli(Department of Blood Transfusion,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《国际检验医学杂志》
CAS
2021年第24期3036-3040,共5页
International Journal of Laboratory Medicine
基金
河北省张家口市重点研发计划项目(2021097D)。
