Analysis of Factors Influencing Bone Metastasis in Prostate Cancer and Diagnostic Value of Serum PSA, CysC and D-D

Xinxin Liu; Chunxiao Zhao; Jing Lin; Baolong Liu

doi:10.56434/j.arch.esp.urol.20247701.10

Analysis of Factors Influencing Bone Metastasis in Prostate Cancer and Diagnostic Value of Serum PSA, CysC and D-D

Arch Esp Urol. 2024 Jan;77(1):72-78. doi: 10.56434/j.arch.esp.urol.20247701.10.

Authors

Xinxin Liu¹, Chunxiao Zhao^{2

3}, Jing Lin¹, Baolong Liu⁴

Affiliations

¹ Hospital Infection Management Department, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, 266000 Qingdao, Shandong, China.
² Department of Spinal Surgery, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, 266000 Qingdao, Shandong, China.
³ Department of Hand and Foot Trauma Surgery, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, 266000 Qingdao, Shandong, China.
⁴ Deptment of Emergency Surgery, Qingdao Hospital of Traditional Chinese Medicine, 266000 Qingdao, Shandong, China.

PMID: 38374016
DOI: 10.56434/j.arch.esp.urol.20247701.10

Abstract

Objective: This study aims to analyse factors influencing bone metastasis in prostate cancer and the diagnostic value of serum prostate-specific antigen (PSA), and D-dimer (D-D) combined with cystatin C (CysC) in bone metastasis of prostate cancer.

Methods: Data of 116 patients with prostate cancer admitted to our hospital were retrospectively analysed. They were divided into two groups: Bone metastasis group (46 cases) and non-bone metastasis group (70 cases). Univariate and multivariate logistic regression analyses were used to determine factors influencing bone metastasis in prostate cancer. The values of serum PSA, D-D and CysC were identified using a receiver operating characteristic diagnostic curve.

Results: Of the 116 patients, 46 had bone metastases and 70 had non-bone metastases. Among 46 patients with bone metastasis, 8 cases (17.39%) had single bone metastasis and 38 cases (82.61%) had multiple bone metastasis. Based on the univariate analysis, bone metastasis was associated with increases in Gleason score, clinical stage, lymph node metastasis, systemic inflammatory response index, fibrinogen to albumin ratio and alkaline phosphatase and fibrinogen levels. The Gleason score was higher than 8 points, the clinical stages ranged from T3 to T4 and the serum levels of PSA, D-D and CysC were higher in the bone metastasis group (p < 0.05). The combined value of serum PSA, D-D and CysC in the diagnosis of bone metastasis in prostate cancer was higher than the three indicators alone.

Conclusions: Lymph node metastasis in T3-T4 clinical stages with Gleason score >8 was a risk factor for bone metastasis in prostate cancer (all p < 0.05). The risk of bone metastasis in patients with prostate cancer increases with increasing Gleason clinical stage and the occurrence of lymph node metastasis. Serum PSA, D-D and CysC have certain diagnostic value in the diagnosis of bone metastasis, and their combination has the highest value.

Keywords: D-dimer; bone metastasis; cystatin C; prostate cancer; prostate-specific antigen.

MeSH terms

Bone Neoplasms* / secondary
Cystatin C
Fibrin Fibrinogen Degradation Products
Humans
Lymphatic Metastasis
Male
Neoplasm Staging
Prostate-Specific Antigen
Prostatic Neoplasms* / pathology
Retrospective Studies

Substances

Prostate-Specific Antigen
fibrin fragment D
Cystatin C
Fibrin Fibrinogen Degradation Products