目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列...目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列腺癌患者的临床资料进行回顾性收集和分析,根据骨扫描的检查结果辅以核磁共振,将盆腔有无骨转移的病人分为前列腺癌骨转移组80例和非骨转移组89例。所有患者在手术前都接受了MRI检查,对血清PSA、ALP、D-二聚体、FIB水平进行定量检测。对不同影像指标与前列腺癌骨转移结果之间的一致性采用Kappa一致性检验;利用单因素和多因素Logistic回归分析,评估mpMRI、ALP、D-二聚体、FIB及其他临床指标在前列腺癌骨转移诊断中的价值。利用受试者工作特征(receiver operating characteristic, ROC)曲线对前列腺癌骨转移中纳入的mpMRI、ALP、D-二聚体、FIB及其联合指标的临床应用价值进行评价。结果:T1WI、T2WI压脂、DWI及mpMRI与前列腺癌骨转移结果比较的Kappa值分别为0.536、0.470、0.629、0.691 (P Objective: To analyze the efficacy of multiparametric MRI (mpMRI) combined with serum ALP, D-dimer, and FIB in the diagnosis of bone metastasis in prostate cancer. Methods: A retrospective collection and analysis of clinical data from 169 prostate cancer patients were conducted. Based on the results of bone scans supplemented by MRI, patients with or without pelvic bone metastasis were divided into the prostate cancer bone metastasis group (80 cases) and the non-bone metastasis group (89 cases). All patients underwent MRI examination prior to surgery, and serum levels of PSA, ALP, D-dimer, and FIB were quantitatively measured. Kappa consistency tests were used to analyze the agreement between different imaging indicators and the results of prostate cancer bone metastasis. Uni- and multivariable logistic regression analyses were performed to evaluate the value of mpMRI, ALP, D-dimer, FIB, and other clinical indicators in the diagnosis of prostate cancer bone metastasis. The clinical application value of mpMRI, ALP, D-dimer, FIB, and their combined indicators in diagnosing prostate cancer bone metastasis was assessed using receiver operating characteristic (ROC) curves. Results: The Kappa values comparing T1WI, T2WI fat suppression, DWI, and mpMRI with the results of prostate cancer bone metastasis were 0.536, 0.470, 0.629, and 0.691, respectively (P < 0.001). Compared to the non-bone metastasis group, the serum levels of ALP, D-dimer, and FIB in the bone metastasis group were significantly higher (P < 0.001). Multivariable logistic regression analysis indicated that mpMRI, ALP, D-dimer, and FIB are independent risk factors for prostate cancer bone metastasis (P < 0.05). The combined indicators showed the best performance, followed by the individual indicators of D-dimer, mpMRI, ALP, and FIB, all of which demonstrated good diagnostic value (P < 0.05). Conclusion: mpMRI, ALP, D-dimer, and FIB all demonstrate certain diagnostic efficacy for prostate cancer bone metastasis. The combined use of these indicators can further enhance diagnostic value, suggesting that they should be considered for broader application in clinical practice.展开更多
目的:探索影响前列腺癌骨转移(prostate cancer bone metastasis,PCBM)的危险因素,建立血液和病理学相关预测模型并分析影响PCBM生存的危险因素。方法:纳入452例PC患者,根据是否发生PCBM分为PCBM组(n=169)和non PCBM组(n=283)。分别使...目的:探索影响前列腺癌骨转移(prostate cancer bone metastasis,PCBM)的危险因素,建立血液和病理学相关预测模型并分析影响PCBM生存的危险因素。方法:纳入452例PC患者,根据是否发生PCBM分为PCBM组(n=169)和non PCBM组(n=283)。分别使用卡方检验、独立样本t检验和Mann-Whitney U检验对组间差异数据进行分析,Logistic回归分析影响PCBM的危险因素,以危险因素为基础构建PCBM临床预测模型,ROC和PR曲线用于验证列线图性能,最后使用Kaplan-Meier绘制PCBM相关生存曲线。结果:通过组间差异和Logistic回归综合分析T分期、N分期、PSA、ISUP、PNI、NLR、PLR、LMR、SII、HRR、HALP和Serum P是影响PCBM的主要危险因素(P<0.05)。以上述危险因素构建了与血液和病理学相关的列线图模型,该模型训练集和验证集的准确度分别为0.972和0.932。生存曲线显示T分期、N分期、PSA和ISUP是影响PCBM生存的主要危险因素。结论:PCBM的影响因素包括病理分期、PSA水平以及特定的血液学指标,本中心构建了相关预测模型,用于预测患者的转移和生存。展开更多
前列腺癌(PCa)是全球男性除肺癌之外的第二大常见的恶性肿瘤,同时也是我国中老年男性最常见的恶性肿瘤之一,骨转移是其常见的并发症之一,骨转移导致的骨相关不良事件(SREs)严重影响患者的生活质量和预后,且我国患者相对而言大部分发现较...前列腺癌(PCa)是全球男性除肺癌之外的第二大常见的恶性肿瘤,同时也是我国中老年男性最常见的恶性肿瘤之一,骨转移是其常见的并发症之一,骨转移导致的骨相关不良事件(SREs)严重影响患者的生活质量和预后,且我国患者相对而言大部分发现较晚,多数患者已出现骨转移等并发症,故早期发现并诊断出前列腺癌,对患者的治疗、生活质量及预后等具有重大影响。现阶段影像学检查因其经济、简便与无创等优势在前列腺癌的应用中备受重视,影像学检查主要包括超声检查、X线、计算机断层扫描(CT)、核磁共振成像(MRI)、单光子发射断层扫描(SPECT/CT)及PET/CT扫描,本文就以上检查方法的目前研究进展进行综述。Prostate cancer (PCa) is the second most common malignant tumor in men worldwide except lung cancer, and it is also one of the most common malignant tumors in middle-aged and elderly men in China. Bone metastasis is one of the common complications, and bone-related adverse events (SREs) caused by bone metastasis seriously affect the quality of life and prognosis of patients, and the majority of patients in China are relatively late detected, and most of the patients have already suffered from complications such as bone metastasis. Therefore, early detection and diagnosis of prostate cancer has a significant impact on patients’ treatment, quality of life and prognosis. At the present stage, imaging examination is highly valued in the application of prostate cancer because of its advantages of economy, simplicity and non-invasiveness, etc. Imaging examination mainly includes ultrasonography, X-ray, computed tomography (CT), magnetic resonance imaging (MRI), single photon emission tomography (SPECT/CT), and PET/CT scanning, and this paper reviews the current research progress of the above methods.展开更多
文摘目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列腺癌患者的临床资料进行回顾性收集和分析,根据骨扫描的检查结果辅以核磁共振,将盆腔有无骨转移的病人分为前列腺癌骨转移组80例和非骨转移组89例。所有患者在手术前都接受了MRI检查,对血清PSA、ALP、D-二聚体、FIB水平进行定量检测。对不同影像指标与前列腺癌骨转移结果之间的一致性采用Kappa一致性检验;利用单因素和多因素Logistic回归分析,评估mpMRI、ALP、D-二聚体、FIB及其他临床指标在前列腺癌骨转移诊断中的价值。利用受试者工作特征(receiver operating characteristic, ROC)曲线对前列腺癌骨转移中纳入的mpMRI、ALP、D-二聚体、FIB及其联合指标的临床应用价值进行评价。结果:T1WI、T2WI压脂、DWI及mpMRI与前列腺癌骨转移结果比较的Kappa值分别为0.536、0.470、0.629、0.691 (P Objective: To analyze the efficacy of multiparametric MRI (mpMRI) combined with serum ALP, D-dimer, and FIB in the diagnosis of bone metastasis in prostate cancer. Methods: A retrospective collection and analysis of clinical data from 169 prostate cancer patients were conducted. Based on the results of bone scans supplemented by MRI, patients with or without pelvic bone metastasis were divided into the prostate cancer bone metastasis group (80 cases) and the non-bone metastasis group (89 cases). All patients underwent MRI examination prior to surgery, and serum levels of PSA, ALP, D-dimer, and FIB were quantitatively measured. Kappa consistency tests were used to analyze the agreement between different imaging indicators and the results of prostate cancer bone metastasis. Uni- and multivariable logistic regression analyses were performed to evaluate the value of mpMRI, ALP, D-dimer, FIB, and other clinical indicators in the diagnosis of prostate cancer bone metastasis. The clinical application value of mpMRI, ALP, D-dimer, FIB, and their combined indicators in diagnosing prostate cancer bone metastasis was assessed using receiver operating characteristic (ROC) curves. Results: The Kappa values comparing T1WI, T2WI fat suppression, DWI, and mpMRI with the results of prostate cancer bone metastasis were 0.536, 0.470, 0.629, and 0.691, respectively (P < 0.001). Compared to the non-bone metastasis group, the serum levels of ALP, D-dimer, and FIB in the bone metastasis group were significantly higher (P < 0.001). Multivariable logistic regression analysis indicated that mpMRI, ALP, D-dimer, and FIB are independent risk factors for prostate cancer bone metastasis (P < 0.05). The combined indicators showed the best performance, followed by the individual indicators of D-dimer, mpMRI, ALP, and FIB, all of which demonstrated good diagnostic value (P < 0.05). Conclusion: mpMRI, ALP, D-dimer, and FIB all demonstrate certain diagnostic efficacy for prostate cancer bone metastasis. The combined use of these indicators can further enhance diagnostic value, suggesting that they should be considered for broader application in clinical practice.
文摘目的:探索影响前列腺癌骨转移(prostate cancer bone metastasis,PCBM)的危险因素,建立血液和病理学相关预测模型并分析影响PCBM生存的危险因素。方法:纳入452例PC患者,根据是否发生PCBM分为PCBM组(n=169)和non PCBM组(n=283)。分别使用卡方检验、独立样本t检验和Mann-Whitney U检验对组间差异数据进行分析,Logistic回归分析影响PCBM的危险因素,以危险因素为基础构建PCBM临床预测模型,ROC和PR曲线用于验证列线图性能,最后使用Kaplan-Meier绘制PCBM相关生存曲线。结果:通过组间差异和Logistic回归综合分析T分期、N分期、PSA、ISUP、PNI、NLR、PLR、LMR、SII、HRR、HALP和Serum P是影响PCBM的主要危险因素(P<0.05)。以上述危险因素构建了与血液和病理学相关的列线图模型,该模型训练集和验证集的准确度分别为0.972和0.932。生存曲线显示T分期、N分期、PSA和ISUP是影响PCBM生存的主要危险因素。结论:PCBM的影响因素包括病理分期、PSA水平以及特定的血液学指标,本中心构建了相关预测模型,用于预测患者的转移和生存。
文摘前列腺癌(PCa)是全球男性除肺癌之外的第二大常见的恶性肿瘤,同时也是我国中老年男性最常见的恶性肿瘤之一,骨转移是其常见的并发症之一,骨转移导致的骨相关不良事件(SREs)严重影响患者的生活质量和预后,且我国患者相对而言大部分发现较晚,多数患者已出现骨转移等并发症,故早期发现并诊断出前列腺癌,对患者的治疗、生活质量及预后等具有重大影响。现阶段影像学检查因其经济、简便与无创等优势在前列腺癌的应用中备受重视,影像学检查主要包括超声检查、X线、计算机断层扫描(CT)、核磁共振成像(MRI)、单光子发射断层扫描(SPECT/CT)及PET/CT扫描,本文就以上检查方法的目前研究进展进行综述。Prostate cancer (PCa) is the second most common malignant tumor in men worldwide except lung cancer, and it is also one of the most common malignant tumors in middle-aged and elderly men in China. Bone metastasis is one of the common complications, and bone-related adverse events (SREs) caused by bone metastasis seriously affect the quality of life and prognosis of patients, and the majority of patients in China are relatively late detected, and most of the patients have already suffered from complications such as bone metastasis. Therefore, early detection and diagnosis of prostate cancer has a significant impact on patients’ treatment, quality of life and prognosis. At the present stage, imaging examination is highly valued in the application of prostate cancer because of its advantages of economy, simplicity and non-invasiveness, etc. Imaging examination mainly includes ultrasonography, X-ray, computed tomography (CT), magnetic resonance imaging (MRI), single photon emission tomography (SPECT/CT), and PET/CT scanning, and this paper reviews the current research progress of the above methods.
