| Objective To analyze the relationship between serum testosterone,PSA and its related indicators(PSAD and FPSA / TPSA)combined with Gleason score and bone metastasis of prostate cancer,and to explore the predictive value of clinical indicators for bone metastasis.Methods The clinical data of 104 patients with prostate cancer diagnosed by postoperative pathology in the Department of Urology,General Hospital of Ningxia Medical University from January 2017 to December 2020 were retrospectively collected.According to the imaging data: 3.0T prostate MRI enhanced + diffusion and whole body bone imaging,the patients were divided into two groups: bone metastasis group(BM)and non bone metastasis group(NBM).The serum testosterone,PSA,PSAD,f PSA / TPSA,Gleason score,ALP and Ki-67 were compared between the two groups.The ROC curve was used to evaluate the clinical value of these indicators in predicting bone metastasis of prostate cancer.Results 1.Of the 104 PCA patients,43 were BM group and 61 were NBM group.The visible metastasis rate was 41.3%.The TPSA,PSAD,ALP,Ki-67 and FPSA / TPSA values of PCA patients in BM group were significantly higher than those in NBM group(P < 0.001);the T value of PCA patients in BM group was significantly lower than that in NBM group(P< 0.001).2.With the increase of TPSA concentration and Gleason score,the proportion of bone metastases increased gradually;for each unit of TPSA concentration increase,the incidence of bone metastases in patients with bone metastases was 1.56 times higher than that in patients without bone metastases,with 31.54ng/ml as the critical value,and the Youden index value was the largest,which was 0.661.The corresponding sensitivity,specificity,positive predictive value and negative predictive value were 90.7%,75.4% and 90.7%,respectively 73.6%、92.2%。 3.There was a negative correlation between T value and bone metastasis,and its or(95% CI)was 1.24(0.89,P < 0.05),The difference was statistically significant(P = 0.023)(≤ 0.05).When t was 238.22ng/dl,Yi was the highest,which was0.858.In BM group,39 patients were lower than this value,and metastasis was as high as90.69%.The sensitivity,specificity,positive predictive value and negative predictive value of Yi were higher than that of non bone metastasis The predictive values were 95.1%,90.7%,90.5% and 91.9% respectively.4.The critical value of FPSA / TPSA was 0.125,and the maximum value of Yi was 0.345.The corresponding sensitivity,specificity,positive predictive value and negative predictive value were 83.7%,50.8%,56.3% and 82.5%,respectively.5.The or value of PSAD was 1.26,the difference was statistically significant(P= 0.015(≤ 0.05).When the critical value was 0.863 and the maximum value of Yi was 0.405,the sensitivity,specificity,positive predictive value and negative predictive value were 65.1%,75.4%,65% and 73.4% respectively.6.The or value of Ki-67 expression was 1.15,and the difference was statistically significant(P = 0.001(≤ 0.05).The critical value of Ki-67 expression was 12.5%,and the maximum value of Yi was 0.662.The sensitivity,specificity,positive predictive value and negative predictive value of Ki-67 expression in predicting bone metastasis were 74.4%,91.8%,86.5% and 83.5%,respectively.7.The or values of ALP and Gleason scores were statistically significant(P > 0.05),and the or values were 1.27 and 56.78 respectively.Conclusion 1.Blood T value,TPSA,PSAD,f PSA / TPSA,ALP,Ki-67 and Gleason score have great value in predicting bone metastasis of prostate cancer.TPSA has the highest diagnostic efficiency,followed by blood T and Ki-67 value.2.There was a negative correlation between blood T value and bone metastasis.When preoperative T value was lower than 238.22ng/dl,PCA patients were more likely to have bone metastasis.3.When TPSA >31.54ng/ml,PSAD > 0.863,Gleason score > 8,ALP > 88.5iu/l,f PSA / TPSA < 0.125,Ki-67 expression > 12.5%,PCA patients were more likely to have bone metastasis. |
PDF Full Text Request