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目的探讨联合检测甲状旁腺相关蛋白(PTHrP)和骨唾液蛋白(BSP)对前列腺癌骨转移的诊断价值。方法选取89例前列腺癌患者,其中骨转移组42例,无骨转移组47例(其中无转移患者26例,骨外转移患者21例)。应用免疫组织化学法检测癌组织标本PTHrP和BSP表达。结果骨转移组PTHrP和BSP的阳性率均明显高于无骨转移组(P均<0.01),且强阳性表达率亦均明显高于后者(P均<0.05);无骨转移组中无转移者和骨外转移者PTHrP和BSP表达无显著差异。Cox比例风险回归模型分析结果示前列腺癌组织中PTHrP和BSP高表达是预测骨转移的主要危险因素(P<0.01),其相对危险度分别为1.348和1.293。Log-rank生存曲线分析结果示前列腺癌患者中PTHrP和BSP高表达者的累积生存概率均明显低于PTHrP和BSP阴性表达者,P均<0.05。结论PTHrP和BSP过表达是早期预测前列腺癌骨转移的良好标志,并可作为前列腺癌患者预后的一项重要预测因子。
Objective To investigate the value of combined detection of PTHrP and BSP in the diagnosis of bone metastasis of prostate cancer. Methods 89 patients with prostate cancer were selected, including 42 cases of bone metastasis and 47 cases of boneless metastasis (including 26 cases without metastasis and 21 cases with bone metastasis). Immunohistochemistry was used to detect the expression of PTHrP and BSP in cancer tissue. Results The positive rates of PTHrP and BSP in the bone metastasis group were significantly higher than those in the non-bone metastasis group (all P <0.01), and the positive rates of PTHrP and BSP in the bone metastasis group were significantly higher than those in the latter (P <0.05) There was no significant difference in the expression of PTHrP and BSP in metastasis and bone metastasis. Cox proportional hazards regression model analysis showed that the high expression of PTHrP and BSP in prostate cancer was the main risk factor for predicting bone metastasis (P <0.01), and the relative risk was 1.348 and 1.293 respectively. The Log-rank survival curve analysis showed that the cumulative survival rates of PTHrP and BSP overexpression in patients with prostate cancer were significantly lower than those in PTHrP and BSP negative patients (all P <0.05). Conclusions Overexpression of PTHrP and BSP are good markers for early prediction of bone metastasis in prostate cancer and may be used as an important predictor of the prognosis of patients with prostate cancer.