血清25-和1,25-二羟基维生素D联合前列腺特异性抗原预测前列腺癌骨转移的价值评估

The value of serum 25-and 1,25-dihydroxyvitamin D combined with prostate-specific antigen in predicting bone metastasis of prostate cancer

目的评估血清25-羟维生素D_(3)[25-(OH)_(2)-VitD_(3)]、1,25-二羟维生素D_(3)[1,25-(OH)_(2)-VitD_(3)]联合前列腺特异性抗原(PSA)预测前列腺癌骨转移的临床价值。方法选择本院泌尿外科2015年2月至2020年2月期间住院治疗的77例前列腺癌患者作为研究对象,根据是否出现骨转移分为骨转移组(35例)和骨未转移组(42例),同期选择30例门诊健康体检者作为对照组。采用放射免疫分析法检测各组血清1,25-(OH)_(2)-VitD_(3)表达水平,采用荧光免疫层析法检测各组血清25-(OH)_(2)-VitD_(3)和PSA表达水平。比较各组血清25-(OH)_(2)-VitD_(3)、1,25-(OH)_(2)-VitD_(3)、PSA表达水平,采用受试者工作特征(ROC)曲线分析单一及联合检测预测前列腺癌骨转移的价值。结果各组血清25-(OH)_(2)-VitD_(3)、1,25-(OH)_(2)-VitD_(3)、PSA表达水平比较差异有统计学意义(P<0.05),骨转移组、骨未转移组血清25-(OH)_(2)-VitD_(3)、1,25-(OH)_(2)-VitD_(3)表达水平明显低于对照组(P<0.05),血清PSA表达水平明显高于对照组(P<0.05),而骨转移组血清25-(OH)_(2)-VitD_(3)、1,25-(OH)_(2)-VitD_(3)表达水平明显低于骨未转移组(P<0.05),血清PSA表达水平明显高于骨未转移组(P<0.05);血清25-(OH)_(2)-VitD_(3)、1,25-(OH)_(2)-VitD_(3)、PSA联合检测的AUC、敏感度及特异度均优于单一检测(P<0.05)。结论血清25-(OH)_(2)-VitD_(3)、1,25-(OH)_(2)-VitD_(3)联合PSA预测前列腺癌骨转移可能具有较好的临床价值。

Objective To investigate the clinical value of serum 25-hydroxyvitamin D_(3)[25-(OH)_(2)-VitD_(3)]and 1,25-dihydroxyvitamin D_(3)[1,25-(OH)_(2)-VitD_(3)]combined with prostate-specific antigen(PSA)in predicting the bone metastasis of prostate cancer.Methods A total of 77 patients with prostate cancer treated during Feb.2015 and Feb.2020 were selected and divided into bone metastasis group(n=35)and non-metastasis metastasis group(n=42).During the same period,30 healthy subjects were enrolled as the control group.After the serum 1,25-(OH)_(2)-VitD_(3) level was detected with radioimmunoassay,and the levels of serum 25-(OH)_(2)-VitD_(3) and PSA were determined with fluorescence immunochromatography,they were compared,and receiver operating characteristic(ROC)curve was used to analyze the value of single and joint detection in predicting the bone metastasis of prostate cancer.Results There were significant differences in the expressions of serum 25-(OH)_(2)-VitD_(3),1,25-(OH)_(2)-VitD_(3),and PSA among the three groups(P<0.05).The bone metastasis group and non-metastasis group had significantly lower expressions of 25-(OH)_(2)-VitD_(3) and 1,25-(OH)_(2)-VitD_(3) but higher PSA than the control group(P<0.05).The bone metastasis group had significantly lower expressions of 25-(OH)_(2)-VitD_(3) and 1,25-(OH)_(2)-VitD_(3) but higher PSA than the non-metastasis group(P<0.05).AUC,sensitivity and specificity of joint detection of serum 25-(OH)_(2)-VitD_(3),1,25-(OH)_(2)-VitD_(3) and PSA were better than those of single detection(P<0.05).Conclusion Serum 25-(OH)_(2)-VitD_(3),1,25-(OH)_(2)-VitD_(3) combined with PSA is effective in predicting the bone metastasis of prostate cancer.