Analysis Of The Risk Factors Of Castration-resistant Prostate Cancer And The Value Of Perineural Invasion In Disease Progression

OBJECTIVE:Screen the risk factors of prostate cancer(PCa)evolving to the castration resistant prostate cancer(CRPC)after androgen deprivation therapy(ADT),and explore the value of prostate biopsy pathology suggesting perineural invasion(PNIb)in disease progression.Methods: A retrospective analysis of the clinical data of 416 prostate cancer patients who were diagnosed by prostate biopsy in the First Affiliated Hospital of Xinjiang Medical University from January 2009 to January 2019 and met the inclusion criteria,including age,initial prostate specific antigen(PSA),Gleason score(GS),clinical T staging,bone metastasis,lymph node metastasis,PNIb,time to progress to CRPC,using COX proportional hazard model to analyze the impact of each clinical data on the time to CRPC progress,Using Kaplan-Meier survival analysis and log-rank test to compare the differences between the groups;according to the pathological results of the puncture,the cases included in the study were divided into PNIb and no PNIb groups,and chi-square test was performed between the groups.Multivariate logistic regression analysis of the correlation between PNIb and risk factors.Results:(1)In univariate analysis,initial PSA,GS,clinical T staging,bone metastasis,lymph node metastasis,lung metastasis and PNIb were all related to the progression time of CRPC(P<0.05);in multivariate analysis,GS,clinical T staging,Bone metastasis and pathology after puncture suggest that nerve invasion are risk factors for prostate cancer to develop into CRPC.(2)The differences in initial PSA,GS and clinical T staging,capsular invasion,bone metastasis,and lung metastasis between the two groups with and without PNIb were statistically significant;the results of multiple logistic regression analysis showed that PNIb and GS,Clinical T staging and capsule invasion are independently related.Conclusion: GS,clinical T staging,bone metastasis and PNIb are poor prognostic factors for disease progression after endocrine therapy;PNIb can effectively assess the progression of prostate cancer and the risk of tumors.