| Background and purpose:The aim of this study was to investigate the predictive value of Prostate-Specific Antigen Density(PSAD)and Gleason Score(GS)combination with alkaline phosphatase(ALP)for bone metastasis in patients with prostate cancer.Methods:We retrospectively reviewed the charts of 108 consecutive patients with newly diagnosed prostate cancer hospitalized in Department of Urology,The People's Hospital of Guangxi Zhuang Autonomous Region between Feb.2013 and Jul.2016,and evaluated the relationships between PSAD,Gleason score,ALP with the results of bone metastasis.The relation of these parameters to postive results of bone metastasis were examined by univariate analyses.Binary logistic regression analyses were used to further investigate the influence of these factors on bone metastasis.The receiver operating characteristics(ROC)curves were analyzed to determine the cutoff value,sensitivity and specificity of the independent correlation factors for predicting bone metastasis.Result: The levels of PSA density,Gleason score and ALP in the metastasisgroup were significantly higher than those without(P < 0.05).Logistic regression analysis identified PSAD,GS and ALP as independent factors correlated with bone metastasis with OR(95% CI)of 20.16(4.33,93.86)(P <0.001),16.01(1.80,143.74)(P=0.013),and 35.40(7.10,176.63)(P < 0.001),respectively.ROC analyses showed PSAD in area under the curve higher than GS and ALP.The GS had the highest sensitivity and NPV,and ALP of had the highest specificity and PPV in metastasis group.When the predictor for bone metastasis was established as PSAD ?0.995,GS?4+3 and PLA?101.5 U/L its sensitivity,specificity,PPV and NPV for positive results were95.1,86.6,81.2and96.7%,respectively.Conclusions: We found that the PSAD and ALP are superior marker for bone metastases compared with GS,Our study suggests that PSAD,GS and ALP should be considered together in order to more accurately predict the bone metastasis of prostate cancer. |
PDF Full Text Request