前列腺癌骨转移的特点及其相关危险因素分析

目的 探讨前列腺癌骨转移的临床特点及其危险因素.方法 回顾性分析2006年6月-2016年6月南昌大学第一附属医院收治的、经穿刺活检或术后病理检查确诊为前列腺癌患者的临床资料,记录首次入院时的一般资料、化验检查结果 及病理切片Gleason评分,分析各临床因素与骨转移发生的关系,明确骨转移发生的相关危险因素.结果 共纳入585例前列腺癌患者,其中发生骨转移228例,无骨转移357例.在骨转移患者中,骨盆转移发生率最高,占81.58%,其次是脊柱转移(63.16%)和肋骨转移(58.33%),锁骨转移最少(14.47%).Logistic回归分析显示年龄<71.5岁、碱性磷酸酶(ALP)>85.5U/L、前列腺特异性抗原(PSA)>79.88μg/L和Gleason评分>7.5分是前列腺癌骨转移的危险因素.ROC曲线分析显示,上述各因素诊断骨转移的灵敏度分别为56.1%、66.7%、68.4%、56.1%,特异度分别为56.6%、81.8%、70.0%、65.3%.结论 前列腺癌骨转移以骨盆转移最为多见,年龄、ALP、PSA及Gleason评分是前列腺癌发生骨转移的危险因素.

Risk factors and characteristics of prostate cancer bone metastases

Objective To analyze the risk factors and characteristics of bone metastases in patients with prostate cancer. Methods Patients who were diagnosed as prostate cancer by biopsy and histopathologic analysis between June 2006 and June 2016 were included in this study. The clinical data of the patients were reviewed, and the demographic data, laboratory examination results and Gleason score were recorded. The correlations between clinical factors and bone metastasis were analyzed, and the risk factors of bone metastasis were identified. Results A total of 585 patients were recruited in this study, including 228 with bone metastasis and 357 without bone metastasis. Of the patients with bone metastasis, the incidence of pelvic metastasis was the highest, accounting for 81.58%, followed by spin (63.16%) and rib (58.33%), and the incidence of clavicle metastasis was the lowest (14.47%). Logistic regression analysis showed that age <71.5 years, alkaline phosphotase >85.5U/L, prostate-specific antigen >79.88μg/L and Gleason score >7.5 were the risk factors of bone metastasis in prostate cancer. ROC curve analysis showed that the sensitivity of diagnosing bone metastasis was 56.1%, 66.7%, 68.4% and 56.1%, and the specificity was 56.6%, 81.8%, 70.0% and 65.3%, respectively for above 4 factors. Conclusions The most common site of bone metastasis in patients with prostate cancer is pelvis. Patients' age, concentrations of plasma ALP and PSA, and Gleason score are the risk factors for bone metastasis in patients with prostate cancer.