前列腺癌患者3年生存的预测因素分析  

Predictive Factors of 3-Year Survival in Patients with Prostate Cancer

作　　者：陈业辉[1] 赵仕佳[1] 仉智[1] 林华欣[1] 李淼沅[1] 聂品[1] 江文[1] 刘燕青[1] 李鹏麾 

机构地区：[1]广州医科大学附属市一医院泌尿外科,广东广州510180

出　　处：《中山大学学报（医学科学版）》2016年第2期300-304,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金(2015A030313731);国家自然科学基金(81273205)

摘　　要：【目的】分析前列腺癌病人的多种临床指标与其3年生存的相关性,为前列腺癌病人预后判断提供依据。【方法】回顾性随访分析341名前列腺癌病人的资料,计算3年总生存率,并应用单因素相关分析及多因素logistic回归分析年龄(AGE)、总前列腺特异性抗原(TPSA)、直肠指检(DRE)、经直肠B超结果(TRUS)、前列腺特异性抗原密度(PSAD)、前列腺移行区体积密度(PSATZ)、肿瘤T2分期,转移情况、Gleason评分、是否接受治疗等指标与病人3年生存的相关性,并对独立相关性因素计算cutoff值及灵敏度、特异度。【结果】本组前列腺癌病人341例,3年的总生存率为57.4%,疾病特异生存率为60.7%。在单因素相关分析中,Gleason评分、肿瘤T2分期、转移情况及是否接受治疗等指标与3年生存均有相关性(P<0.05),多因素logistic回归分析结果提示仅有Gleason评分及接受治疗这两个指标是3年生存的独立相关性因素,Gleason评分是正相关,接受治疗是负相关,P值分别是0.047、0.010,OR(95%CI)分别是1.018(0.837,1.239)、0.321(0.135,0.759)。Gleason评分cutoff值是7.5,灵敏度和特异度分别是35.8%、75.3%。【结论】Gleason评分和接受治疗是前列腺癌病人3年生存的预测因素。Gleason评分越高及没有接受治疗者,3年生存的可能性越低。[ Objective ] To investigate the correlation between the clinical variables and the 3-year survival rate of patients with prostate cancer. [ Methods] The clinical data of 341 patients with prostate cancer were collected and analyzed. The 3-year survival rate was calculated. The correlation between 3-year survival rate and age （AGE）, total prostate specific antigen （TPSA）, digital rectal examination （DRE）, transrectal ultrasound （TRUS）, total prostate specific antigen （TPSA）, prostate specific antigen density （PSAD）, prostate specific antigen density of transition zone （PSATZ）, tumor stage （TNM）, metastasis, Gleason score, treatments were analyzed by one-way ANOVA and logistic regression analysis. The cutoff value, sensitivity and specificity of the independent correlation factors were calculated. [ Results ] The 3-year survival rate and disease-specific survival rate of 341 prostate cancer patients were 57.4% and 60.7%, respectively. Tumor staging, metastasis, Gleason score and treatments were correlated to 3-year survival （P 〈 0.05）, whereas Gleason score and treatment were independent correlation factors of 3-year survival by logistic regression analysis. The cutoff value of Gleason Score was 7.5. The sensitivity and specificity of Gleason Score were 35.8% and 75.3%, respectively. [Conclusion] Gleason score and treatment arepredictive factors of 3-year survival in patients with prostate cancer. Higher Gleason score or no treatments cause less 3-year survival.

关 键 词：前列腺癌 预测因素 GLEASON评分 治疗 

分 类 号：R73[医药卫生—肿瘤]