系统免疫炎症指数联合白蛋白-纤维蛋白原比值对初诊前列腺癌患者骨转移的预测价值

Predictive value of systemic immune-inflammation index and albumin-fibrinogen ratio for bone metastasis in patients newly diagnosed with prostate cancer

目的探讨系统免疫炎症指数(SII)联合白蛋白-纤维蛋白原比值(AFR)对初诊前列腺癌患者骨转移的预测价值。方法回顾性分析305例前列腺癌患者的临床资料,其中骨转移组108例、无骨转移组197例,采用二元Logistic回归分析SII、AFR对前列腺癌骨转移率的影响,采用受试者工作特征曲线分析SII、AFR对前列腺癌骨转移的预测效能。结果骨转移组SII为500.22(350.19~697.46)×109/L,AFR为11.53(9.91~12.87),无骨转移组分别为350.03(258.49~529.15)×109/L、13.84(11.69~15.95)(Z=10.335,P<0.001;Z=12.101,P<0.001)。在校正混杂因素后,SII每增加1个标准差,骨转移优势比(OR)为1.001(1.000,1.002),AFR每增加1个标准差,骨转移OR为0.812(0.717,0.919)。SII、AFR单独和联合检测的曲线下面积分别为0.671、0.717、0.747。单独检测SII的最佳截断值为411.49×109/L,敏感性为68.52%,特异性为60.91%;单独检测AFR的最佳截断值为13.35,敏感性为84.26%,特异性为55.84%。SII+AFR联合检测的敏感性为72.22%,特异性为70.05%。SII+AFR联合检测的曲线下面积高于单独检测SII(Z=2.396,95%CI:0.014~0.139,P<0.001)和AFR(Z=2.062,95%CI:0.001~0.059,P<0.001)。结论SII、AFR与初诊前列腺癌患者骨转移相关,SII+AFR联合检测效能高于单独检测,对初诊前列腺癌患者骨转移具有更好的预测价值。

Objective To investigate the predictive value of systemic immune-inflammation index(SII)and albumin-fibrinogen ratio(AFR)for bone metastasis in patients with newly diagnosed prostate cancer.Methods Clinical data of 305 patients with prostate cancer was retrospectively reviewed,including 108 patients in the bone metastasis group and 197 patients in the no bone metastasis group.After adjusting for confounding factors,the effects of SII and AFR on bone metastasis rate of prostate cancer were analyzed by binary Logistic regression,the receiver operating characteristic curve was used to analyze the predictive power of SII and AFR for bone metastasis of prostate cancer.Results The SII of the bone metastasis group was 500.22(350.19~697.46)×109/L,and the AFR was 11.53(9.91~12.87).The non bone metastasis group was 350.03(258.49~529.15)×109/L and 13.84(11.69~15.95),respectively,with statistical significance(Z=10.335,P<0.001;Z=12.101,P<0.001).After adjusting for confounding factors,for every 1 standard deviation increase in SII,the odds ratio(OR)for bone metastasis was 1.001(1.000,1.002),and for every 1 standard deviation increase in AFR,the OR for bone metastasis was 0.812(0.717,0.919).The areas under the curves for SII and AFR individual and combined detection are 0.671,0.717,and 0.747,respectively.The optimal cutoff value for detecting SII alone was 411.49×109/L,with a sensitivity of 68.52%and a specificity of 60.91%;The optimal cutoff value for detecting AFR alone was 13.35,with a sensitivity of 84.26%and a specificity of 55.84%.The sensitivity of SII+AFR combined detection was 72.22%,and the specificity was 70.05%.The area under the curve of SII+AFR combined detection was higher than that of SII alone detection(Z=2.396,95%CI:0.014-0.139,P<0.001)and AFR(Z=2.062,95%CI:0.001-0.059,P<0.001).Conclusion SII and AFR were associated with bone metastasis in patients with newly diagnosed prostate cancer,and the efficiency of SII+AFR was higher than that of the single indicator.Therefore,the combination of SII and AFR has better predictive value.