高瘤負(fù)荷骨轉(zhuǎn)移前列腺癌患者列線圖預(yù)后模型的構(gòu)建與評(píng)估

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Construction and evaluation of a nomogram prognostic model for patients of prostate cancer with high tumor load bone metastases

HUANG Xin1，HOU Yakun1，TAO Ning2，ZHUO Tao1，RENAGULI Aihaiti1，ZHANG Kaige1，YAO Miao1，AN Hengqing1

（1.Department of Urology，The First Affiliated Hospital，2.Public Health Institute，Xinjiang Medical University，Urumqi 830054，China）

ABSTRACT：ObjectiveTo identify the risk factors of patients of bone metastatic prostate cancer with high tumor load progressed to castration resistant prostate cancer （CRPC），establish a nomogram prediction model and evaluate its consistency and accuracy.MethodsA total of 164 patients diagnosed by puncture and imaging during 2012 and 2022 were included.The general characteristics were analyzed with IBM SPSS software；the variables were screened with Cox regression；the multivariate risk factors with P<0.05 were included in the nomogram prediction model.The consistency and prediction accuracy of the model were evaluated with C，index，receiver operating characteristic （ROC） curve and calibration chart.ResultsIn univariate analysis，initial prostate，specific antigen （PSA），prostate，specific antigen density （PSAD），Gleason score，T stage，alkaline phosphatase （ALP） and lactate dehydrogenase （LDH） were correlated with CRPC （P<0.05）.Multivariate analysis showed that initial PSA，Gleason score，T stage，ALP and LDH were independent risk factors of CRPC （P＜0.05）.Based on the above five risk factors，a nomogram prediction model was constructed.The C，index was 0.801，the area under ROC curve （AUC） of 1，year progression，free survival （PFS） was 0.701 （0.608-0.794），and the AUC of 2，year PFS was 0.857 （0.767-0.947）.The calibration chart showed that the prediction probability of the model was in good agreement with the actual probability.ConclusionInitial PSA，Gleason score，T stage，ALP and LDH are independent risk factors of CRPC.The predictive model may be an effective tool for the initial diagnosis of high tumor load bone metastatic prostate cancer，but more data are needed for internal and external validation.

KEY WORDS：metastatic prostate cancer；high tumor load；castration，resistant；nomogram；initial PSA；Gleason score；clinical T stage；alkaline phosphatase；lactate dehydrogenase

摘要：目的篩選高瘤負(fù)荷骨轉(zhuǎn)移前列腺癌患者進(jìn)展至去勢(shì)抵抗（CRPC）階段的危險(xiǎn)因素，建立列線圖預(yù)測(cè)模型并評(píng)估其一致性和準(zhǔn)確性，為判斷患者疾病進(jìn)展時(shí)機(jī)提供預(yù)測(cè)工具。（剩余11417字）