Analysis Of Related Factors Of Castration-resistant Prostate Cancer

Purpose:To study the related factors of prostate cancer patients progressing to castration-resistant prostate cancer(CRPC)after androgen deprivation therapy.Materials and Methods:The clinical data of 83 prostate cancer patients diagnosed and treated with androgen deprivation therapy in The First Afiliated Hospital of Soochow University from 2015 to 2018 were retrospectively analyzed.Chi-square test was used to analyze whether there was any difference between the two groups of data,and Kaplan-Meier survival analysis and log-rank test were used to compare the difference of time to CRPC.Univariate and multivariate cox regression analysis were used to analyze the correlation between CRPC and initial PSA level,the time to PSA nadir,PSA nadir,Gleason score,white blood cells,neutrophils,lymphocytes,hemoglobin,platelets,albumin and C-reactive protein before treatment.Results:After androgen deprivation therapy,46 patients progressed to CRPC,the time to progression was 3?53 months with the median time of 13.5 months,and 37 patients did not enter CRPC.The PSA nadir(P=0.010),initial PSA level(P=0.002),Gleason score(P=0.041),platelets(P<0.001),C-reactive protein(P=0.005),neutrophils(P=0.029)and lymphocytes(P=0.018)were significantly different between the CRPC group and the non-CRPC group.In univariate cox regression analysis,the time to PSA nadir(P=0.005),initial PSA value(P=0.001),PSA nadir(P=0.009),Gleason score(P=0.011),platelet level before treatment(P=0.023)and C-reactive protein(P=0.018)were correlated with CRPC progression.Multivariate cox regression analysis showed that the time to PSA nadir(P<0.001),PSA nadir(P=0.012)and Gleason score(P=0.005)were all independent risk factors for prostate cancer patients to develop CRPC after androgen deprivation therapy.The shorter the time to PSA nadir,the higher the PSA nadir,and the higher the Gleason score,the easier it is for patients to progress to CRPC.Conclusion:The short time to PSA nadir,the high PSA nadir and high Gleason score are independent risk factors for prostate cancer patients to develop CRPC after androgen deprivation therapy.