Analysis Of Factors Related To MCRPC Progression In Patients With High Tumor Burden MHSPC After Endocrine Therapy

OBJECTIVE: to study the factors related to the progression of Metastatic castration-resistant prostate cancer(m CRPC)after endocrine therapy in patients with high metastatic hormone-sensitive prostate cancer(m HSPC),the risk prediction model can be used to guide clinical practice and provide help for clinical management of disease.Methods:1.A total of 101 patients with high tumor burden(with visceral metastasis(seminal vesicle invasion)and/or ≥ 4 bone metastases and at least one metastatic prostate cancer beyond the central axis(Crista and pelvis)who were first diagnosed in the department of Urology of the First Affiliated Hospital of Nanchang University from January 2010 to August 2020 and received endocrine therapy(castration plus anti-androgen)for the first time were collected,after the initial diagnosis of high tumor load m HSPC,the patients were followed up until the end of this study.Collect follow-up data: the time of endocrine therapy,record the age,weight,initial prostate specific antigen(PSA),albumin,prostate specific antigen density(PSAD),inflammation indicators(neutrophils),and neutrophils of the patients who were followed up Percentage,lymphocytes,platelets,abnormal liver enzymes(aspartate aminotransferase),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),D dimer,Alkaline phosphatase(ALP),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),minimum PSA value,time to minimum PSA(TTN),lactate dehydrogenase(LDH),Hemoglobin,Gleason score(follow up until November 2020).To study the factors related to the progression of Metastatic castration-resistant prostate cancer(m CRPC)after endocrine therapy in patients with high tumor-load metastatic hormone-sensitive prostate cancer(m HSPC),and to screen the high risk factors for the progression of m CRPC in patients with high tumor-load m HSPC,to determine the relationship between m CRPC and the clinical factors involved in this study,and to determine the prognosis of patients with high tumor load m HSPC after endocrine therapy,may provide the help for the clinical comprehensive management disease.To help provide patients with personalized,optimal treatment of clinical treatment program2.Statistical methods: Using SPSS to analyze single factor and Cox regression,Kaplan-Meier method to analyze survival function,make ROC curve,and build risk prediction model.Results:1.Among the 101 patients with highly metastatic hormone-sensitive prostate cancer,the age was(68.79 ± 6.98),the youngest was 52 years old and the oldest was 86 years old,the initial PSA P25 was 156.25 Ng/ml,P75 was 363 Ng/ml;Gleason score(8.39 ± 1.22),minimum 4,Maximum 10;weight(61.35 ± 10.93)kg,minimum 40 kg,maximum 90.2 kg;hemoglobin(120.60 ± 22.97)g/l,minimum 58g/l,maximum 167 g/l;albumin(39.19 ± 5.40)g/l,minimum 24.4 g/l,neutrophil(4.01 ± 1.53)109,minimum 1.26×109,maximum 7.61×109,neutrophil(66.75 ±21.88)%,minimum 21.7%,maximum 92.2%,lymphocyte(1.38 ± 0.49)109,the minimum value was 0.44×109/L,the maximum value was 3.12109/L;the NLR(3.18± 1.86)was 0.88,the maximum value was 13.42;the platelet(202.29 ± 85.56)was×109/L,the minimum value was 65.5×109/L,the maximum value was 75×109/L;the Plr(162.96 ± 91.57)was 32.98,the maximum value was 625;ASPARTATE aminotransferase(27.74 ± 16.26)U/L,minimum 12U/L,maximum 102U/L;PT(11.77 ± 2.62)s,minimum 9.3s,maximum 35.1s;Aptt(29.27 ± 5.10)s,minimum20.8s,maximum 47.3s;TT(18.32 ± 3.23)s,minimum 4.19s;D dimer(3.95 ±7.44)with a minimum of 0.07 and a maximum of 36.98;P25 of Alkaline phosphatase was 109.2 mmol/L and P75 was 164.06 mmol/L;the initial PSAD P25 was 2.91(ng/ml.cm3),the P75 value is 10.06 ng/(ml.cm3);Gleason score(8.39 ± 1.22).2.In this study,43 of 101 patients with high tumor-load MHSPC progressed to m CRPC after endocrine therapy,that is,42.57% of patients with high tumor-load metastatic hormone-sensitive prostate cancer progressed to m CRPC after endocrine therapy.3.Single factor analysis,the statistical analysis of Alkaline phosphatase,NLR,PLR,minimum PSA,TTN,Lactate dehydrogenase,hemoglobin,Gleason scores showed that there was significant difference in m CRPC(p < 0.05)Age,Body Weight,first FPSA,albumin,PSAD,inflammatory index(Neutrophil),neutrophil percentage,lymphocyte,platelet,hepatic enzyme abnormality(aspartate Aminotransferase),PT,Aptt,TT dimer showed no significant difference in the progression of m CRPC in patients with high tumor load after receiving endocrine therapy(p > 0.05).4.Single factor analysis of Alkaline phosphatase,NLR,PLR,minimum PSA value,time to lowest PSA value(TTN),Lactate dehydrogenase,hemoglobin,Gleason score,etc.,then the data of these factors are included in SPSS for Cox multivariate regression analysis,the results were as follows: NLR,minimum PSA,TTN,Lactate dehydrogenase,hemoglobin,Gleason score were independent risk factors for m CRPC progression after endocrine therapy in prostate cancer patients with high tumor load,however,Alkaline phosphatase,PLR and Gleason scores had no significant effect on the progression of m CRPC after Endocrine Therapy(P<0.05).CONCLUSION:1.The m CRPC progress rate was 42.57% in patients with high tumor load m HSPC after endocrine therapy.2.In univariate analysis,Alkaline phosphatase,NLR,PLR,minimum PSA,TTN,Lactate dehydrogenase,hemoglobin,and high tumor load mhcpc were the influencing factors of m CRPC.3.In multifactorial analysis,NLR,minimum PSA value,TTN,Lactate dehydrogenase,hemoglobin,Gleason score were independent risk factors for m CRPC progression after endocrine therapy in patients with high tumor load m HSPC There was no significant association between Alkaline Phosphatase,PLR and m CRPC in patients with high tumor load mHSPC.