碳酸酐酶-9检测对前列腺癌预后评估的临床意义

Clinical significance of carbonic anhydrase enzyme IX detection applied to prostate cancer prognosis

目的探讨检测碳酸酐酶_9于前列腺癌患者的危险程度及预后的临床意义。方法回顾我院2008年1月1日至2011年4月30日期间前列腺癌患者的病例资料，并进行电话随访。根据患者预后分为死亡组和存活组，通过组间单因素比较及多因素Logistic回归分析等方法评价各因素与患者不良预后的相关性。结果经随访共调查143例患者，与存活组相比，死亡组的年龄、体重指数、吸烟史、前列腺炎病史、癌胚抗原、前列腺特异性抗原、总胆固醇、碳酸酐酶_9与患者不良预后有显著相关性。将该指标引入多因素Logistic回归分析，得出最佳线性方程由吸烟史、前列腺炎病史、前列腺特异性抗原、总胆固醇、碳酸酐酶_9构成。再将上述相关危险因素行ROC曲线检验并计算曲线下面积，判断相关危险因素的检验效能，纳入碳酸酐酶母后曲线下面积为0．841。曲线下面积较未纳入时明显增加、曲线Youden指数较未纳入时显著升高。结论碳酸酐酶_9升高将增加前列腺癌患者不良预后的风险，将该指标纳入前列腺癌的评测体系可进一步增强评估该病患者高危风险的能力。

Objective To explore the significance of risk and prognosis evaluation by detection of CA9 in patients with prostate cancer. Methods The clinical data of all patients with prostate cancer in our hospital from January lst,2008 to April 30th,2011 were reviewed and followed up by telephone. Based on the prognosis, patients were divided into dead group and survival group; The single factor comparison by groups, multivariate logistic regression analysis and other methods were applied to evaluate the correlation between various factors and a poor prognosis in patients. Results A total of 143 patients were followed up. Compared with the survival group, in the dead group the poor prognosis in patients had significant cor- relation with age, BMI, smoking history, prostatitis history, CEA, PSA, TC, and CA9. The indicators were in- troduced to multi-factor logistic regression analysis ,and the best linear equation was composed of smoking history, history of prostatitis, PSA ,TC, and CAg. Then the risk factors mentioned above were tested by the ROC curve, and the area under the curve was calculated to determine the test performance of these risk factors. The area under the curve of was 0. 841 when CA9 was included. The area under the curve and the Youden index were not increased significantly compared with those when CA9 was not included. Conclu- sion Elevated CA9 will increase the risk of poor prognosis in prostate cancer patients, so including this indicator into the evaluation system for prostate cancer can further enhance risk assessment.