| ObjectiveStatistical analysis of clinically relevant factors in patients with prostate cancer and bone metastases,and to explore its relationship with survival prognosis after endocrine therapy.MethodsA total of 80 patients with prostate cancer associated with bone metastases who had received Endocrine therapy as the primary therapy in Department of Urology of Second Affiliated Hospital of Nanchang University from January 2010 to July 2017 were enrolled and followed retrospectively.(The follow-up time was until December 2018).Results1.Gleason score,tumor stage(T stage),bone metastasis grade,alkaline phosphatase and serum initial PSA line correlation analysis were performed in 80 prostate cancer patients.Gleason score was positively correlated with bone metastasis grade(r=0.351,P=0.001).ALP was positively correlated with bone metastasis(r=0.325,P=0.003);tumor stage(T stage)was positively correlated with Gleason score(r=0.308,P=0.006);Gleason score was not associated with alkaline phosphatase or initial PSA(P>0.05);tumor stage was not related to bone metastasis grade,PSA and alkaline phosphatase(P>0.05).ALP and bone metastasis were not related to PSA(P>0.05).2.The ROC curve of continuous variables in clinical factors was analyzed.The area under curve of albumin and uPSA was >0.5,which had prognostic value(P<0.05).The best predictive value of uPSA was 0.210 ng/ml and the Youden index was 0.554.The diagnostic sensitivity is 86.2%,the specificity is 68.2%;the best predicted margin of albumin is 38.225 g/L,the Youden index is 0.340,the diagnostic sensitivity is 70.7%,the specificity is 60.3%,and age,hemoglobin,ALP,PSA,PLR and NLR had no prognostic value(P>0.05).3.In univariate analysis,uPSA,Gleason score,preoperative bone-related events,bone metastasis grading,pelvic and abdominal lymph node metastasis,survivalrelated single factor analysis,the overall survival rate difference between the groups were statistically significant(P<0.05);There was no significant difference in overall survival between age,albumin,clinical stage(T stage),castration method,and risk of prostate cancer(P>0.05).4.Clinical factors statistically(uPSA,Gleason score,preoperative bone-related events,bone metastasis grade,pelvic and abdominal lymph node metastasis)in the univariate analysis were included in the COX model for survival multivariate analysis.:uPSA(P=0.013,HR=0.392,95% CI 0.187,0.823),Gleason score(P=0.024,HR=1.870,95% CI 1.088,3.215)and bone metastasis grade(P=0.006,HR=2.071,95% CI 1.233,3.480)is an independent prognostic factor for survival time after endocrine therapy in patients with prostate cancer and bone metastases.There was no statistically significant correlation between pelvic and abdominal lymph node metas-tasis,preoperative bone-related events,and survival time after endocrine therapy in patients with prostate cancer and bone metastases.Conclusions1.The patients with prostate cancer associated with bone metastases diagnosed and treated by endocrine therapy in our hospital had a higher age,a later clinical stage,and a higher Gleason score,and were concentrated in the high-risk group.2.Among the clinically relevant factors,Gleason score was positively correlated with bone metastasis grade,ALP was positively correlated with bone metastasis grade,and tumor stage(T stage)was positively correlated with Gleason score.3.In the univariate analysis,uPSA,Gleason score,preoperative bone-related events,bone metastasis grade,and pelvic and abdominal lymph node metastasis were the influencing factors of survival prognosis after endocrine therapy in patients with prostate cancer and bone metastases;4.In multivariate analysis,this study showed that uPSA<0.210 ng/ml,lower Gleason score and lower bone metastasis grade may indicate that the patients with prostate cancer associated with bone metastases have longer survival time after endocrine therapy. |
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