【摘要】 目的探讨外周凝血指标及临床因素对初诊前列腺癌患者骨转移的预测价值。方法回顾性分析2016年1月至2019年10月于郑州大学第一附属医院初次就诊、穿刺活检病理确诊为前列腺癌的332例患者的临床资料,根据骨扫描的结果分为骨转移组和未转移组,采用组间对照研究、单因素和多因素Logistic回归分析评估外周凝血指标及各临床因素对初诊前列腺癌骨转移的预测价值。结果共332例前列腺癌患者纳入研究,其中骨转移118例,无骨转移214例。骨转移组中位D-二聚体为0.33(0.140～0.779)mg/L,显著高于未转移组0.11(0.069～0.186)mg/L;多因素Logistic回归显示:D-二聚体、临床T分期、Gleason评分、总前列腺特异性抗原(tPSA)、碱性磷酸酶(ALP)与前列腺癌骨转移独立相关(P<0.05);D-二聚体诊断初诊前列腺癌骨转移受试者工作特征曲线下面积为0.800,最佳截断值为0.19mg/L,灵敏度和特异度分别为70%、76%。结论 D-二聚体与初诊前列腺癌骨转移相关,可与临床T分期、Gleason评分、tPSA、ALP等协同评估初诊前列腺癌患者骨转移的可能性。更多还原

【Abstract】 Objective To investigate the value of peripheral blood coagulation indexes and clinical factors in predicting bone metastasis in patients with newly diagnosed prostate cancer.Methods The clinical data of 332 patients with prostate cancer diagnosed by puncture biopsy during Jan.2016 and Oct.2019 were retrospectively analyzed.According to the results of bone scan,the patients were divided into bone metastasis group and non-metastasis group.The predictive value of peripheral coagulation indexes were evaluated with intergroup control study,univariate and multivariate Logistic regression analyses.Results Of all patients,118 had bone metastasis and 214 had not.The median D-dimer in the bone metastasis group was 0.33(0.140-0.779)mg/L,which was significantly higher than that in the non-metastasis group 0.11(0.069-0.186)mg/L.Multivariate Logistic regression analysis showed that D-dimer,clinical T stage,Gleason score,total prostate-specific antigen(tPSA)and alkaline phosphatase(ALP)were independently correlated with bone metastasis(P<0.05).The area under the ROC curve of D-dimer in the diagnosis of newly diagnosed prostate cancer was 0.800;the best cut-off value was 0.19 mg/L;the sensitivity and specificity were 70% and 76%,respectively.Conclusion D-dimer is associated with bone metastasis of newly diagnosed prostate cancer,and can be used together with clinical T stage,Gleason score,tPSA and ALP to evaluate the possibility of bone metastasis.更多还原