前列腺癌骨转移进展为去势抵抗的预测因素分析

谭信韬; 黄卓韦; 刘秋礼; 彭松; 黄义强; 唐堂; 江军

doi:10.16016/j.1000-5404.202009081

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前列腺癌骨转移进展为去势抵抗的预测因素分析

临床医学 | 更新时间：2026-01-09

- 前列腺癌骨转移进展为去势抵抗的预测因素分析
- Predictive factors for progression to metastatic castration-resistant prostate cancer
- 第三军医大学学报 2021年43卷第5期页码：425-431
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金青年科学基金(81802558);军队保健专项科研课题(17BJZ13)
- DOI：10.16016/j.1000-5404.202009081
  中图分类号：
- 收稿：2020-09-10，
  
  纸质出版：2021-03-15
- 稿件说明：
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谭信韬, 黄卓韦, 刘秋礼, 等. 前列腺癌骨转移进展为去势抵抗的预测因素分析[J]. 第三军医大学学报, 2021,43(5):425-431.

Xintao TAN, Zhuowei HUANG, Qiuli LIU, et al. Predictive factors for progression to metastatic castration-resistant prostate cancer[J]. Journal of Third Military Medical University, 2021, 43(5): 425-431.
谭信韬, 黄卓韦, 刘秋礼, 等. 前列腺癌骨转移进展为去势抵抗的预测因素分析[J]. 第三军医大学学报, 2021,43(5):425-431. DOI： 10.16016/j.1000-5404.202009081.

Xintao TAN, Zhuowei HUANG, Qiuli LIU, et al. Predictive factors for progression to metastatic castration-resistant prostate cancer[J]. Journal of Third Military Medical University, 2021, 43(5): 425-431. DOI： 10.16016/j.1000-5404.202009081.

摘要

Abstract

Objective

To explore the predictive factors of metastatic prostate cancer progression to castration resistance and establish a risk prediction model.

Methods

Clinical data of 118 prostate cancer patients with bone metastasis who were diagnosed in our department from January 2010 to July 2020

initially received adjuvant endocrine therapy (AET) and then advanced to metastatic castration-resistant prostate cancer (mCRPC) were collected and retrospectively analyzed. The clinical information

including age

having diabetes or not

taking metformin or not

prostate specific antigen (PSA) level at diagnosis

nadir levels of PSA and testosterone

time to the nadirs

Gleason score

number of bone metastases

and serum levels of alkaline phosphatase

hemoglobin

albumin

lactate dehydrogenase

uric acid and cystatin C were collected and analyzed.

Chi

-square test was used to compare the differences of factors between groups with rapid and slow onset of CRPC. Kaplan-Meier survival analysis and Cox multivariate risk proportional regression model were used to compare the time difference of progression to CRPC in different groups. Cox risk proportional regression model was used to analyze and evaluate the effect of these factors on the time of CRPC progression

and a risk prediction model was established

and then the receiver operating characteristic (ROC) curve was used to detect the accuracy of the model.

Results

The median time for progression to CRPC was 17 (9.5~28.0) months. Univariate analysis indicated that the PSA nadir level

time to PSA nadir level

levels of alkaline phosphatase and lactate dehydrogenase

and number of bone metastases were significantly correlated with the time of progression to CRPC (

0.05). The results of multivariate analysis showed that the PSA nadir level (

=2.549

95%

: 1.565~4.151

0.001)

time to PSA nadir level (

=0.373

95%

: 0.227~0.612

0.001)

number of bone metastases (

=2.393

95%

: 1.292~4.43

=0.006)

lactate dehydrogenase level (

=1.681

95%

: 1.045~2.703

=0.032) were independent risk factors for short-term progression to CRPC. Based on these 4 independent risk factors

a risk prediction model was established. The equation is pi=1.788×(the PSA nadir level)-1.275×(the time to PSA nadir level) +0.441×(lactate dehydrogenase level) +1.114×(number of bone metastases)-1.5. The area under ROC curve was 0.812 (95%

: 0.731~0.893

0.001

β=0.041). The sensitivity

specificity and Youden index were 0.803

0.718 and 0.521

respectively.

Conclusion

The PSA nadir level

time to PSA nadir value

number of bone metastases

lactate dehydrogenase level are independent risk factors for progression to mCRPC after androgen deprivation therapy (ADT) in prostate cancer patients with bone metastasis. Based on these 4 factors

the establishment of CRPC prediction model can improve the accuracy of prediction.

关键词

Keywords

references

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