CLINICAL AND MORPHOLOGICAL FEATURES OF BONE METASTASES DIAGNOSIS IN PATIENTS WITH PROSTATE CANCER
DOI:
https://doi.org/10.15407/oncology.2023.01.063Keywords:
prostate cancer, bone metastases, diagnosis, clinico-morphological features.Abstract
Aim: to highlight the current clinical, laboratory and morphological methods of prediction and diagnosis of bone metastases (BM) in the prostate cancer (PC) patients. Objects and methods: in the prospective non randomized clinical study were included 521 patients with localized PCR, that underwent radical prostatectomy (RP) and were observed until the development of BM. Main group included 411 (78.8%) patients with Grade group (GrG) 2–5, control group – 110 (21.2%) patients with GrG 1 that hadn’t progression of the disease with development of BM. We evaluated all relevant clinical, laboratory, morphology indicators and predictors of PCR BM development. Every 3 months postoperatively, the levels of total PSA, calcium, and alkaline phosphatase (ALP) in blood serum were determined. Results: according to the data of the initial levels of total PSA in all studied groups, the average levels in GrG 2,3 and GrG 4,5 without the development of BM were 10.6 and 21.6 ng/ml; in GrG 2,3 and GrG 4,5 with the development of BM – 19.8 and 25.7 ng/ml. Among 411 PCR patients with GrG 2–5, perineural invasion (PNI) was detected in postoperative material in 197 patients, among whom 25 (12.4%) developed BM as opposed to 12 (5.9%) patients with BM without PNI. In patients with the development of CM, the level of LF activity in blood serum is almost twice as high as in patients without metastases, regardless of the initial PSA values. LF, calcium, and hemoglobin levels are sensitive laboratory markers of CM development in patients with radiologically confirmed CM compared with patients without CM. The median time to the development of BM was 26 months in patients with GrG 2,3 and 16 months in patients of the GrG 4,5. Conclusion: total assessment of PNI in post-surgery histological material, PSA level, ALP level, calcium, hemoglobin can be an effective tool for predicting risk of PCR BM development.
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