实用医学杂志 ›› 2021, Vol. 37 ›› Issue (24): 3197-3201.doi: 10.3969/j.issn.1006⁃5725.2021.24.020

• 医学检查与临床诊断 • 上一篇    下一篇

骨转换标志物及其与总前列腺特异抗原、白细胞介素⁃6构建的预测模型在前列腺癌骨转移中的研究

周林1 王正芳1 俞俊杰2 吴银霞3 韩崇旭1 王广洲1   

  1. 扬州大学临床医学院,江苏省苏北人民医院1 医学检验科,2 泌尿外科,3 肿瘤科(江苏扬州 225001)

  • 出版日期:2021-12-25 发布日期:2021-12-25
  • 通讯作者: 王广洲 E⁃mail:wgzwgz007001@sina.com
  • 基金资助:
    江苏省“六大人才高峰”高层次人才项目(编号:WSW255);中国博士后项目(编号:2017M611755);江苏省扬州市重点医学人才项目(编号:ZDRC20185,ZDRC201861)

Clinical study of bone turnover markers and prediction model constructed by bone turnover markers,IL⁃6 and tPSA in prostate cancer bone metastasis

ZHOU Lin*,WANG Zhengfang,YU Junjie,WU Yinxia,HAN Chongxu,WANG Guangzhou. #br#   

  1. Department of Medical LaboratoryClinical Medical College of Yangzhou University Northern Jiangsu Peoples HospitalYangzhou 225001China
  • Online:2021-12-25 Published:2021-12-25
  • Contact: WANG Guangzhou E⁃mail:wgzwgz007001@sina.com
  • Supported by:


摘要:

目的 研究骨转换标志物及其与总前列腺特异抗原(total prostate specific antigen,tPSA)、白细胞介素⁃6(interleukin⁃6,IL⁃6)构建的预测模型在前列腺癌骨转移中的临床应用价值。方法 比较分析骨钙素(N⁃MID osteocalcin,Osteocalcin)、总 I 型前胶原氨基末端肽(total procollagen type 1 amino⁃terminal pro⁃peptide,TPINP)、β⁃异构化的 C⁃端肽 I 型胶原片段(β⁃CrossLaps,β⁃CTx)、tPSA、IL⁃6 在发生和未发生骨转移的前列腺癌患者血清中的表达差异;运用 logistic 回归分析,从上述血清标志物中筛选出前列腺癌骨转移的危险因素。并通过筛选的危险因素,构建前列腺癌骨转移的预测模型,进一步绘制 ROC 曲线评估该预测模型在前列腺癌骨转移中的诊断效能。结果 Osteocalcin、TPINP、β⁃CTx 及 tPSA 、IL⁃6 在前列腺癌骨转移患者中的表达水平均显著高于未发生骨转移患者(P < 0.05);其中 Osteocalcin、TPINP、tPSA、IL⁃6 为前列腺癌骨转移的独立危险因素(OR = 1.088、1.021、1.037、1.415,P < 0.05);通过上述危险因素构建的预测模型为 logit(P)=(-5.058)+0.085×(Osteocalcin)+0.020×(TPINP)+0.037×(tPSA)+0.347×(IL⁃6),该模型在前列腺癌骨转移诊断中的曲线下面积(AUC)=0.908(P < 0.001)。结论 前列腺癌骨转移患者存在异常的骨代谢;且由 Osteocalcin、TPINP、tPSA、IL⁃6 构建的数学模型能够较好地预测前列腺癌骨转移的发生。

关键词: 前列腺癌,  , 骨转移,  , 白细胞介素?6, 骨转换标志物, 预测模型, 诊断

Abstract:

Objective To investigate the clinical application value of bone turnover markers and predic⁃ tion model established by bone turnover markers and PSA and IL⁃6 for prostate cancer bone metastasis. Methods A comparative analysis was conducted for the expression level of serum N ⁃MID Osteocalcin(Osteocalcin),total procollagen type 1 amino⁃terminal pro⁃peptide(TPINP),β⁃isomerized C⁃terminal pro⁃peptide type I collagen Frag⁃ ment(β⁃CTx),total prostate specific antigen(tPSA),and interleukin⁃6(IL⁃6)in prostate cancer patients with or without bone metastasis. Logistic regression analysis was used to screen out the relevant risk factors for prostate cancer bone metastasis from the above serum markers;and based on the screened risk factors,a prediction model for prostate cancer bone metastasis was constructed,whose diagnostic efficacy for prostate cancer bone metastasis was evaluated by ROC curve. Results The expression level of serum Osteocalcin,TPINP,β⁃CTx,tPSA and IL⁃6 in prostate cancer patients with bone metastasis were significantly higher than that in those without bone metastasis (P < 0.05);among them,serum Osteocalcin,TPINP,tPSA,and IL⁃6 were risk factors for prostate cancer bone metastasis ,with OR value of 1.088,1.021,1.037,1.415 respectively(P<0.05). the prediction model constructed by the above risk factors was logit(P)=(-5.058)+0.085×(Osteocalcin)+0.020×(TPINP)+0.037×(tPSA)+0.347× (IL⁃6),and the area under the curve(AUC)of this model in the diagnosis of prostate cancer bone metastasis was 0.908(P < 0.001). Conclusion Abnormal bone metabolism exists in patients with prostate cancer bone metasta⁃ sis,and the prediction model constructed by Osteocalcin,TPINP,tPSA,and IL ⁃6 can predict the occurrence of prostate cancer bone metastasis.

Key words:

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prostate cancer, bone metastases, interleukin ?6, bone turnover markers, predictive model, diagnosis