| 魏 英,蔡维敏,王 飞,吴清晖,康新立.血清睾酮联合红细胞分布宽度、白蛋白碱性磷酸酶比值对腹腔镜前列腺癌根治术后生化复发的预测价值[J].,2023,(4):755-760 |
| 血清睾酮联合红细胞分布宽度、白蛋白碱性磷酸酶比值对腹腔镜前列腺癌根治术后生化复发的预测价值 |
| Predictive Value of Serum Testosterone Combined with Red Blood Cell Distribution Width and Albumin Alkaline Phosphatase Ratio for Biochemical Recurrence after Laparoscopic Radical Prostatectomy |
| 投稿时间：2022-07-08 修订日期：2022-07-31 |
| DOI：10.13241/j.cnki.pmb.2023.04.030 |
| 中文关键词: 前列腺癌 腹腔镜前列腺癌根治术 睾酮 红细胞分布宽度 白蛋白碱性磷酸酶比值 生化复发 预测价值 |
| 英文关键词: Prostate cancer Laparoscopic radical prostatectomy Testosterone Red blood cell distribution width Albumin alkaline phosphatase ratio Biochemical recurrence Predictive value |
| 基金项目:海南省自然科学基金项目（2016813128） |
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| 摘要 目的：分析血清睾酮联合红细胞分布宽度（RDW）、白蛋白碱性磷酸酶比值（AAPR）对腹腔镜前列腺癌根治术（LRP）后生化复发的预测价值。方法：选取2017年1月～2019年1月海南省人民医院收治的90例接受LRP治疗的前列腺癌（PCa）患者，根据LRP后是否生化复发将分为生化复发组（n=34）和无生化复发组（n=56）。收集PCa患者基础资料，并检测两组术前血清睾酮、RDW、AAPR水平。采用多因素Cox回归分析LRP后生化复发的影响因素，受试者工作特征（ROC）曲线分析血清睾酮、RDW、AAPR对LRP后生化复发的预测价值。结果：随访3年，90例PCa患者LRP后生化复发34例，生化复发率为37.78％。单因素分析显示，生化复发组与年龄、PSA、Gleason评分、病理分期、睾酮、AAPR、RDW有关（P＜0.05）。多因素Cox回归分析显示，年龄增加、PSA＞20 ng/mL、Gleason评分8分、病理分期pT3期、RDW升高为LRP后生化复发的独立危险因素，睾酮升高、AAPR升高为独立保护因素（P＜0.05）。ROC曲线分析显示，血清睾酮、RDW、AAPR单独与联合预测LRP后生化复发的曲线下面积（AUC）分别为0.771、0.754、0.772、0.922，三项联合预测LRP后生化复发的AUC大于单独预测（P＜0.05）。结论：RDW升高是LRP后生化复发的危险因素，血清睾酮、AAPR升高是保护因素，可作为LRP后生化复发的辅助预测指标，血清睾酮、RDW、AAPR联合预测LRP后生化复发的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the predictive value of serum testosterone combined with red blood cell distribution width (RDW) and albumin alkaline phosphatase ratio (AAPR) for biochemical recurrence after laparoscopic radical prostatectomy (LRP). Methods: 90 prostate cancer (PCa) patients who were treated with LRP in Hainan Provincial People's Hospital from January 2017 to January 2019 were selected, and they were divided into biochemical recurrence group (n=34) and non biochemical recurrence group (n=56) according to whether biochemical recurrence occurred after LRP. The basic data of PCa patients were collected, and the serum levels of testosterone, RDW and aapr were measured before operation. Multivariate Cox regression was used to analyze the influencing factors of biochemical recurrence after LRP, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum testosterone, RDW and AAPR for biochemical recurrence after LRP. Results: Following up for 3 years, 34 cases of 90 PCa patients had biochemical recurrence after LRP, and the biochemical recurrence rate was 37.78%. Univariate analysis showed that biochemical recurrence group was related to age, PSA, Gleason score, pathological stage, testosterone, AAPR and RDW (P＜0.05). Multivariate Cox regression analysis showed that age increase, PSA > 20 ng/mL, Gleason score of 8 scores, pathological stage pT3 and RDW increase were independent risk factors for biochemical recurrence after LRP, and testosterone increase and AAPR increase were independent protective factors (P＜0.05). ROC curve analysis showed that the area under curve (AUC) of serum testosterone, RDW and AAPR alone and combination in predicting biochemical recurrence after LRP were 0.771, 0.754, 0.772 and 0.922, respectively, the AUC of biochemical recurrence after LRP predicted by the three combined factors was greater than that predicted by alone (P＜0.05). Conclusion: The increase of RDW is a risk factor for biochemical recurrence after LRP and the increase of serum testosterone and aapr are protective factors, and which can be used as an auxiliary predictor of biochemical recurrence after LRP. The combination of serum testosterone, RDW and AAPR has a high value in predicting biochemical recurrence after LRP. |
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