Retrospective analysis of risk factors for bone metastasis in newly diagnosed prostate cancer patients.

Abstract

The aim of the study was to analyze the clinical data of newly diagnosed prostate cancer (PCa) patients with bone metastasis and to explore the relevant risk factors. The clinical data of 251 patients with PCa, who were initially diagnosed in our hospital from February 2015 to October 2021, were retrospectively analyzed. According to the whole-body bone scan results, patients were divided into the bone metastasis group (n = 66) and the non-bone metastasis group (n = 185). The patient's age, total prostate-specific antigen (TPSA), free PSA (fPSA), prostate volume, alkaline phosphatase (ALP), Gleason score, erythrocyte sedimentation rate (ESR), and pelvic lymph node metastasis were collected. Univariate correlation and multivariate regression analyses, together with receiver operating characteristic curve, were used to analyze PCa bone metastasis-related factors. The incidence of bone metastasis in newly diagnosed PCa was about 26.29% (66/251). Among them, the incidence of pelvic metastasis was the highest, at 78.78% (52/251), and multiple bone metastases were significantly higher than single bone metastasis (80.31% vs. 19.69%). Univariate correlation analysis indicated that age, Gleason score, ESR, TPSA, ALP, fPSA/PSA, capsular infiltration, and pelvic lymph node metastasis (p < 0.05) were highly correlated with PCa bone metastasis. Multivariate Logistic regression analysis showed that TPSA (95% CI: 0.977-1.284, p = 0.007), ALP (95% CI: 1.008-1.080, p = 0.016), Gleasons core (95% CI: 2.110-82.349, p = 0.006), ESR (95% CI: 1.062-1.104, p = 0.003), and pelvic lymph node metastasis (95% CI: 1.537--33.239, p = 0.012) were independent risk factors for bone metastasis of PCa. The cut-off values for TPSA, ALP, Gleason score, and ESR were 33.78 ng/ml, 73.65 U/L, 7.5, and 23.5 mm/h, respectively. Additionally, the respective sensitivities for TPSA, ALP, Gleason score, and ESR were 81.8%, 75.8%, 68.2% and 77.3%, and the respective specificities was 90.3%, 98.9%, 98.4%, and 74.6%. TPSA, ALP, Gleason score, ESR and pelvic lymph node metastasis are independent risk factors for bone metastasis of PCa.