碱性磷酸酶、乳酸脱氢酶及Gleason分级用于评估低风险转移性激素敏感型前列腺癌预后的价值

Value of alkaline phosphatase,lactate dehydrogenase and Gleason grades in evaluating the prognosis of low-risk metastatic hormone-sensitive prostate cancer

目的探究碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)及Gleason分级用于评估低风险转移性激素敏感型前列腺癌(mHSPC)预后的价值,为低风险mHSPC患者的诊疗提供科学参考。方法回顾性分析2015年至2021年丽水市人民医院低风险mHSPC患者,以出现去势抵抗性前列腺癌(CRPC)作为不良预后的主要结局指标,将48例出现CRPC的患者纳入观察组,未出现CRPC的48例患者纳入对照组。比较两组患者ALP、LDH和Gleason分级状况,采用受试者工作特征(ROC)曲线分析ALP、LDH、Gleason分级对mHSPC出现不良预后的预测作用。结果观察组患者ALP和LDH水平明显高于对照组,观察组Gleason分级4~5级患者占比明显高于对照组(P<0.05)。高ALP(≥300 U/L)、高LDH(≥200 U/L)、高Gleason分级(4~5级)三者联合曲线下面积为0.879,灵敏度为92.1%,特异度为87.6%。结论高ALP、高LDH、高Gleason分级是低风险mHSPC患者发生不良预后的相关因素,联合使用可为低风险mHSPC患者的临床诊治方案提供重要参考。

Objective To explore the value of alkaline phosphatase(ALP),lactate dehydrogenase(LDH)and Gleason grades in evaluating the prognosis of low-risk metastatic hormone-sensitive prostate cancer(mHSPC),and to provide scientific reference for the diagnosis and treatment of low-risk mHSPC patients.Methods A retrospective analysis was conducted on low-risk mHSPC patients in Lishui People′s Hospital from 2015 to 2021,taking castration-resistant prostate cancer(CRPC)as the main outcome indicator of poor prognosis.48 patients with CRPC were included as the observation group,and 48 patients without CRPC were selected as the control group.The ALP,LDH and Gleason grades of the two groups were compared,and the predictive effects of ALP,LDH and Gleason grades on poor prognosis of mHSPC were analyzed by receiver operating characteristic(ROC)curve.Results ALP and LDH levels in observation group were significantly higher than those in control group,and the proportion of Gleason grade 4-5 patients in observation group was significantly higher than that in control group(P<0.05).The area under curve of high ALP(≥300 U/L),high LDH(≥200 U/L)and high Gleason grades(4-5 grade)combination was 0.879,sensitivity was 92.1%specificity was 87.6%.Conclusions High ALP,high LDH and high Gleason grades are correlated factors with poor prognosis in low-risk mHSPC patients,and the combined use can provide an important reference for the clinical diagnosis and treatment of low-risk mHSPC patients.