摘要
目的分析白蛋白球蛋白比值(AGR)、前列腺特异性抗原(PSA)联合Gleason评分对局限性前列腺癌患者预后的预测价值。方法回顾性分析98例局限性前列腺癌患者的临床资料,以患者治疗后是否发展为去势抵抗性前列腺癌(CRPC)分为CRPC组(n=31)及非CRPC组(n=67),比较两组患者治疗前AGR、PSA、Gleason评分,应用Logistic分析模型分析AGR、PSA、Gleason评分与局限性前列腺癌患者发展为CRPC的相关性,应用受试者工作曲线(ROC)分析AGR、PSA、Gleason评分联合预估局限性前列腺癌患者发展为CRPC的预测价值。分别比较不同AGR、PSA、Gleason评分局限性前列腺癌患者的无进展生存期(PFS)。结果CRPC组AGR水平显著低于非CRPC组(P<0.05);CRPC组PSA水平、Gleason评分显著高于非CRPC组(P<0.05)。经Logistic分析模型分析,AGR水平与局限性前列腺癌患者发展为CRPC呈负相关(P<0.05),PSA水平、Gleason评分与局限性前列腺癌患者发展为CRPC呈正相关(P<0.05)。ROC曲线中,AGR、PSA、Gleason评分联合预估局限性前列腺癌患者发展为CRPC的曲线下面积(AUC)为0.849,敏感度为87.10%,特异度为64.18%。高AGR水平患者PFS显著高于低AGR水平患者,高PSA水平患者PFS显著短于低PSA水平患者,高Gleason评分患者PFS显著短于低Gleason评分患者(P<0.05)。结论AGR、PSA、Gleason评分与局限性前列腺癌患者发展为CRPC密切相关,可为术后早期识别CRPC高危患者、及时制定诊疗方案提供数据支持。
Objective To analyze the predictive value of albumin-to-globulin ratio(AGR),prostate specific antigen(PSA)combined with Gleason score on the prognosis of patients with localized prostate cancer.Methods The clinical data of 98 patients with localized prostate cancer were retrospectively analyzed.According to whether the patients developed into castration-resistant prostate cancer(CRPC)after treatment,they were divided into CRPC group(n=31)and non-CRPC group(n=67).The AGR,PSA and Gleason score before treatment were compared between the 2 groups of patients.Logistic analysis model was used to analyze the correlation between AGR,PSA,Gleason score and progression to CRPC in patients with localized prostate cancer.Receiver operating characteristic curve(ROC)was applied to analyze the predictive value of the combination of AGR,PSA and Gleason score on predicting the progression to CRPC in patients with localized prostate cancer.The progression-free survival(PFS)was compared among patients with localized prostate cancer of different AGR,PSA and Gleason score.Results The AGR in CRPC group was significantly lower than that in non-CRPC group(P<0.05).The PSA level and Gleason score in CRPC group were significantly higher compared with those in non-CRPC group(P<0.05).Logistic analysis model showed that the AGR was negatively correlated with the progression to CRPC in patients with localized prostate cancer(P<0.05),and PSA level and Gleason score were positively correlated with progression to CRPC in patients with localized prostate cancer(P<0.05).According to ROC curve,the area under the curve(AUC),sensitivity and specificity of the combination of AGR,PSA and Gleason score on predicting the progression to CRPC in patients with localized prostate cancer were 0.849,87.10% and 64.18%.The PFS of patients with high AGR level was significantly longer than that in patients with low AGR level,and the PFS of patients with high PSA level was significantly shorter than that in patients with low PSA level,and the PFS of patients with high Gleason score was significantly shorter than that in patients with low Gleason score(P<0.05).Conclusion AGR,PSA and Gleason score are closely related to the progression to CRPC in patients with localized prostate cancer,and can provide data support for the early i-dentification of patients with high-risk CRPC and the timely formulation of diagnosis and treatment plan.
作者
王丽华
范璐璐
任妍
WANG Lihua;FAN Lulu;REN Yan(Zhengzhou Yihe Hospital Affiliated to Henan University,Zhengzhou,450000)
出处
《实用癌症杂志》
2023年第6期1022-1026,共5页
The Practical Journal of Cancer
