用Cox模型对前列腺癌相关临床检查的多因素生存分析  

Multivariate survival analysis model of protate cancer with a Cox model

作　　者：刘汀[1,2] 王霄英[1] 王义[3] 

机构地区：[1]北京大学第一医院影像科,北京100034 [2]北京大学首钢医院影像中心 [3]北京大学首钢医院泌尿外科

出　　处：《北京大学学报（医学版）》2009年第2期184-187,共4页Journal of Peking University:Health Sciences

摘　　要：目的:研究磁共振成像(magnetic resonance imaging,MRI)及其他常规临床检查方法对前列腺特异性抗原(prostate specific antigen,PSA)异常者潜伏期前列腺癌早期检出的相关风险程度,为临床PSA异常者的随访提供优化方案。方法:分析85例PSA异常者的临床检查及随访资料,运用Cox比例风险模型对前列腺癌相关的多种检查手段进行分析。结果:PSA增幅、MRI检查、PSA密度、超声检查、年龄、直肠指检对前列腺特异性抗原PSA异常者潜伏期前列腺癌检出的相对危险度(relativerisk,RR)值分别为4.661、4.060、3.607、1.019、1.001、0.566,其中PSA增幅、MRI检查差异有统计学意义,P值均为0.022。结论:对于PSA异常者的随访,PSA增幅结合MRI检查结果在随访过程中指导临床穿刺,对前列腺癌的早期检出具有比较有效的作用。Objective：To study the correlations between the clinical examinations and latent prostate cancer in old males with abnormal PSA values and provide them with prospective and reasonable programs. Methods： The clinical data of 85 old male adults with abnormal PSA values were collected from three to five years. The clinical examinations about prostate cancer patients were evaluated by Cox multivariate survival analysis. Results： During the follow-up period, clinical prostate cancer was detected in 12 of the 85 patients and the overall proportion was 14.1% （ 12/85 ）. Multivariate analysis revealed that amplification of PSA, MR examination, PSA density, ultrasound, age, digital rectal examination had different relative risk values,which were 4. 661 （P =0. 022） ,4. 060（P =0. 022） ,3. 607（P =0. 219） ,1. 019（P = 0. 982） ,1. 001 （P =0. 987） and 0. 566（P =0. 487） ,respectively. The amplification of PSA and MR examination showed statistical significance （ P 〈 0. 05 ）. Conclusion： For abnormal PSA value adults, amplification of PSA combined with MR examination is more valuable to direct puncturation during the follow-up period and is helpful to detect latent prostate cancer.

关 键 词：前列腺癌 磁共振成像 前列腺特异抗原 生存分析 

分 类 号：R737.25[医药卫生—肿瘤]