目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列腺癌患者的临床资料进行回顾性收集和分析,根据骨扫描的检查结果辅以核磁共振,将盆腔有无骨转移的病人分为前列腺癌骨转移组80例和非骨转移组89例。所有患者在手术前都接受了MRI检查,对血清PSA、ALP、D-二聚体、FIB水平进行定量检测。对不同影像指标与前列腺癌骨转移结果之间的一致性采用Kappa一致性检验;利用单因素和多因素Logistic回归分析,评估mpMRI、ALP、D-二聚体、FIB及其他临床指标在前列腺癌骨转移诊断中的价值。利用受试者工作特征(receiver operating characteristic, ROC)曲线对前列腺癌骨转移中纳入的mpMRI、ALP、D-二聚体、FIB及其联合指标的临床应用价值进行评价。结果:T1WI、T2WI压脂、DWI及mpMRI与前列腺癌骨转移结果比较的Kappa值分别为0.536、0.470、0.629、0.691 (P Objective: To analyze the efficacy of multiparametric MRI (mpMRI) combined with serum ALP, D-dimer, and FIB in the diagnosis of bone metastasis in prostate cancer. Methods: A retrospective collection and analysis of clinical data from 169 prostate cancer patients were conducted. Based on the results of bone scans supplemented by MRI, patients with or without pelvic bone metastasis were divided into the prostate cancer bone metastasis group (80 cases) and the non-bone metastasis group (89 cases). All patients underwent MRI examination prior to surgery, and serum levels of PSA, ALP, D-dimer, and FIB were quantitatively measured. Kappa consistency tests were used to analyze the agreement between different imaging indicators and the results of prostate cancer bone metastasis. Uni- and multivariable logistic regression analyses were performed to evaluate the value of mpMRI, ALP, D-dimer, FIB, a
目的:系统评价地诺单抗在治疗前列腺癌骨转移中的有效性和安全性。方法:检索PubMed、EMBASE、Cochrane、Web of Science、中国生物医学文献数据库、中国知网、万方医学数据库,纳入相关文献。采用Cochrane风险偏倚评估工具对纳入文献质量进行评价,并提取有效数据。使用Revman 5.4和RStudio软件进行meta分析,并绘制森林图。结果:meta分析共纳入6项随机对照试验。结果显示,与对照组相比,地诺单抗明显降低了骨相关事件的风险(HR=0.78,95%CI 0.62~0.93)。在安全性方面,与对照组相比,并未增加总不良事件、严重不良事件及通用毒性标准3级或更高级别不良事件的风险。结论:地诺单抗能够延长首次骨相关事件发生的时间,并在安全性方面表现良好。然而,由于本研究的局限性,仍需开展高质量、大样本、多中心的随机对照试验以进一步验证本研究结果。