血清Cys-C、Hcy对前列腺癌患者骨转移的预测价值分析

Analysis of predictive value of serum Cys-C and Hcy for bone metastasis in prostate cancer patients

目的:探究前列腺癌(PCa)患者发生骨转移的影响因素及血清胱抑素C(Cys-C)、同型半胱氨酸(Hcy)对PCa骨转移的预测价值。方法:选取2021年6月—2023年7月某院就诊的PCa患者86例为研究对象,根据放射性核素骨显像诊断是否发生骨转移分为骨转移组(40例)和无骨转移组(46例)。采用单因素、多因素Logistic回归方程分析PCa患者发生骨转移的影响因素;ROC分析血清Cys-C、Hcy单独及联合检测对PCa患者骨转移的预测价值。结果:单因素分析显示,2组间年龄、体质量指数、有无淋巴结转移比较差异无统计学意义(P>0.05);骨转移组临床T分期≥T2c、Gleason评分≥8分患者比例及血清总前列腺特异性抗原(PSA)、Cys-C、Hcy水平高于无骨转移组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,临床T分期≥T2c、Gleason评分≥8分及高PSA、Cys-C、Hcy水平均是影响PCa患者骨转移的独立危险因素(P<0.05)。ROC分析显示,血清Cys-C、Hcy预测PCa患者发生骨转移的AUC分别为0.855、0.625;二者联合检测的AUC为0.945,特异度为0.826,灵敏度为0.900。结论:血清Cys-C、Hcy联合检测对PCa患者骨转移有较高预测价值,可与患者临床T分期、Gleason评分、PSA水平等共同评估患者病情,对指导临床后续治疗意义重大,具有较高的临床应用价值。

Objective:To investigate the influencing factors of bone metastasis in prostate cancer(PCa)patients and the predictive value of serum cystatin C(Cys C)and homocysteine(Hcy)for PCa bone metastasis.Methods:86 PCa patients who visited a hospital from June 2021 to July 2023 were selected as the research subjects.Based on the diagnosis of bone metastasis by radionuclide bone imaging,they were divided into a bone metastasis group(40 cases)and a non bone metastasis group(46 cases).Univariate and multivariate logistic regression equations were used to analyze the influencing factors of bone metastasis in PCa patients;ROC analysis was conducted on the predictive value of serum Cys C and Hcy detection alone and in combination for bone metastasis in the PCa patients.Results:Univariate analysis showed no statistically significant differences in age,body mass index,and lymph node metastasis between the two groups(P>0.05).The proportion of patients with clinical T stage≥T_(2)c and Gleason score≥8 in the bone metastasis group,as well as the serum levels of total prostate-specific antigen(PSA),Cys C,and Hcy,was higher than that in the non bone metastasis group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that clinical T stage≥T_(2)c,Gleason score≥8,and high PSA,Cys C,and Hcy levels were independent risk factors for bone metastasis in PCa patients(P<0.05).ROC analysis showed that the AUC predicted by serum Cys C and Hcy for bone metastasis in PCa patients was 0.855 and 0.625,respectively.The AUC of the combined detection of the two was 0.945,with specificity being 0.826,and sensitivity being 0.900.Conclusion:The combined detection of serum Cys C and Hcy has high predictive value for bone metastasis in PCa patients,and can be used together with clinical T staging,Gleason score,PSA level,etc.to evaluate the patient's condition.It is of great significance in guiding clinical follow-up treatment and has high clinical application value.