前列腺癌骨转移的预测因素

发布时间：2018-01-19 21:38

本文关键词： 前列腺癌骨转移预测因素　出处：《南方医科大学学报》2016年02期 　论文类型：期刊论文

【摘要】：目的分析前列腺癌骨转移病人多种临床因素与骨转移的相关性,探索前列腺癌病人骨转移的预测因素。方法采用组间对照研究、单因素相关性分析及多因素Logistic回归分析等统计学方法,对45例前列腺癌骨转移病例和同期35例前列腺癌无骨转移病例的年龄、ALP、PSA、ESR、Gleason评分、病理免疫组化中的雄激素受体(AR)表达及ki-67表达进行分析,探索上述指标与前列腺癌骨转移的关系及对骨转移诊断的预测价值。结果在各指标组间对照比较中,骨转移组的各项指标均明显高于非骨转移组,差异有统计学意义(P0.05)。在单因素相关分析中,年龄、ALP、PSA、ESR、Gleason评分、AR表达及Ki-67表达等与骨转移均有相关性(P0.05)。在多因素Logistic回归分析中,年龄、ALP、ESR、Ki-67表达等指标不是骨转移的独立相关性因素(P0.05)。PSA、Gleason评分及AR表达是骨转移的独立性因素,P值分别是0.008、0.013、0.005,OR(95%CI)分别是1.005(1.001,1.009)、5.356(1.431,20.039)、18.594(2.460,140.524)。PSA、Gleason评分及AR表达的cutoff值分别是67.1 ng/m L、7.5、2.5,灵敏度分别是55.6%、75.6%、84.0%,特异度分别是97.1%、82.9%、91.4%。结论血PSA、前列腺癌组织Gleason评分及雄激素受体阳性表达程度是前列腺癌骨转移的预测因素,年龄、ALP、PSA、ESR、ki-67表达等指标并不能准确预测骨转移的发生。
[Abstract]:Objective to analyze the correlation between clinical factors and patients with multiple bone metastasis of prostate cancer with bone metastasis, explore the predictive factors of prostate cancer patients with bone metastasis. The control group method, correlation analysis of single factor and multi factor Logistic regression analysis and other statistical methods, 45 cases of anterior column cases and adenocarcinoma period of bone metastasis in 35 cases of prostate cancer the age of bone metastasis, ALP, PSA, ESR, Gleason score, androgen receptor immunohistochemistry (AR) in the analysis of expression and Ki-67, to explore the relationship between the indexes and the bone metastasis of prostate cancer and bone metastases to the diagnostic predictive value. Results in each index between the groups, the indicators bone metastasis group were significantly higher than those in non bone metastasis group, the difference was statistically significant (P0.05). In univariate analysis, age, ALP, PSA, ESR, Gleason score, AR expression and Ki-67 expression were bone metastasis and There is a correlation between the (P0.05). In a multivariate Logistic regression analysis, age, ALP, ESR, Ki-67 expression index is not independent of bone metastasis related factors (P0.05).PSA, Gleason score and AR expression were independent factors of bone metastasis, P values were 0.008,0.013,0.005, OR (95%CI) were 1.005 (1.001,1.009), 5.356 (1.431,20.039), 18.594 (2.460140.524).PSA, Gleason score and the expression of AR and cutoff values were 67.1 ng/m, L, 7.5,2.5, sensitivity were 55.6%, 75.6%, 84%, the specificity was 97.1%, 82.9%, 91.4%. of blood PSA, prostate cancer and androgen receptor Gleason expression level score predictive factors of prostate cancer bone metastasis age, ALP, PSA, ESR, Ki-67 expression and other indicators can not accurately predict the incidence of bone metastasis.

【作者单位】：广州医科大学附属市一医院泌尿外科;广州医科大学附属市一医院核医学科;
【基金】：国家自然科学基金(81273205) 广东省自然科学基金(2015A030313731)~~
【分类号】：R737.25
【正文快照】： 前列腺癌在欧美等发达国家老年男性中是常见的恶性肿瘤中排第2位,目前在美国前列腺癌的发病率排名已超过肺癌的发病率,成为第1位危害男性健康的肿瘤[1-2]。在我国,前列腺癌的发病率正以迅猛之势逐年递增[3]。前列腺癌容易发展成远处转移,尤其是骨转移最为常见,国外的临床研究

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