前列腺癌根治术后生化复发的危险因素——单中心301例临床分析  

Risk factors of biochemical recurrence after radical prostatectomy ： clinical analysis of 301 cases in a single-center

作　　者：高旭[1] 王海峰[1] 方梓宇 鲁欣[1] 王燕[1] 李耀明[1] 马春飞[1] 施振凯 施挺[1] 孙颖浩[1] 

机构地区：[1]第二军医大学长海医院泌尿外科,上海200433

出　　处：《中华泌尿外科杂志》2014年第3期191-194,共4页Chinese Journal of Urology

基　　金：国家自然基金项目（81172076）

摘　　要：目的 探讨前列腺癌患者的临床特点及影响前列腺癌根治术后生化复发率的相关危险因素.方法 选取2001年1月至2010年2月收治的前列腺癌患者301例.年龄51 ～81岁,平均69岁.术前经TURP确诊26例,经活检病理诊断275例.Gleason评分：＜7分135例,≥7分166例.临床分期：T1a～1b期26例（8.6％）,T1c期91例（30.2％）,T2a期64例（21.3％）,T2b期100例（33.2％）,T2c期12例（4.0％）,T3a期8例（2.7％）.PSA平均值为19.9 μg/L.根据年龄分为高龄组（＞70岁）161例和低龄组（≤70岁）140例,低龄组PSA值明显高于高龄组,差异有统计学意义（P=0.003）,两组的临床分期（P=0.156）和Gleason评分（P=0.138）比较差异均无统计学意义.301例患者均行根治性前列腺切除术,均为经腹膜外途径.比较两组患者年龄、PSA、穿刺阳性针数比例、Gleason评分、临床分期及无生化复发率的差异.结果 本组301例患者的年龄、PSA、穿刺阳性针数比例、临床分期是影响术后生化复发率的主要因素.高龄组术后5年无生化复发率（93.0％）明显高于低龄组（87.0％）,差异有统计学意义（P＜0.05）.结论 我中心前列腺癌根治术患者中高龄组术后无生化复发率明显高于低龄组,患者的年龄、PSA、穿刺阳性针数比例、临床分期是影响前列腺癌根治术后生化复发率的主要因素.Objective To analyze the risk factors of biochemical recurrence after radical prostatec- tomy. Methods Data were prospectively collected for 301 consecutive patients undergoing radical prosta- teetomy between Jan. 2001 and Feb. 2010. The average patient age was 69 （ranged from 51 to 81 ） years. Of whom, 26 cases were diagnosed after TURP, and 275 cases were diagnosed by prostate biopsy. 135 cases were with Gleason score less than 7, while 166 cases were with higher Gleason score. There were 26 cases in clinical stage T^- TH,（8.6%） , while 91 cases in Th（30.2%） , 64 cases in T2,,（21.3%） , 100 cases in T21, （33.2%）, 12 cases in T2,（4.0%）, 8 eases in T3,（2.7%）, respectively. These patients were divided into older group （aged more than 70 years） and younger group （aged less than 70 years）. There was significant difference in PSA （P = 0.003） between the two groups, while there was no differenee between their Gleason score （P = 0.138） and clinical stage （P = 0.156）. All radieal prostatectomies were performed by three expe- rienced surgeons through extraperitoneal approach. Patients who accepted radical prostatectomy in our center had higher PSA and Gleason score than that of the foreign cases. The differences between the two groups in the age, PSA, clinical stage, positive biopsy core rate were compared. Results By analyzing the data of these 301 patients, we found that PSA, age, clinical stage, positive biopsy core rate could affect the bio-chemical recurrence after radical prostatectomy in prostate cancer patients. Besides, elderly patients had sig- nificantly higher biochemical recurrence rate （ 93.0% ） than younger patients （ 87.0% ）. Conclusions PSA, age, clinical stage, positive biopsy core rate are the risk factors of biochemical recurrence after radical prostatectomy. However, Gleason score had no significant effect on biochemical recurrence in prostate cancer patients.

关 键 词：前列腺肿瘤 生化复发 年龄 前列腺癌根治术 

分 类 号：R737.25[医药卫生—肿瘤]