根治性前列腺癌切除术后患者生化复发的危险因素分析  

Analysis of risk factors for biochemical recurrence after radical prostatectomy

作　　者：万福庆[1] 王赞礼 冯子熠 张学聪[2] 

机构地区：[1]河南省周口市中心医院泌尿外科,河南周口466000 [2]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《中国现代医生》2016年第10期44-46,49,共4页China Modern Doctor

摘　　要：目的分析根治性前列腺癌切除术（RP）后患者生化复发（BCR）的危险因素。方法回顾性分析2006年1月~2014年12月进行RP治疗的486例前列腺癌患者的临床和随访资料,记录患者术前、术中、术后和随访的相关参数。根据是否术后出现BCR,将患者分为复发组和非复发组。比较两组患者相关参数差异,运用Cox回归模型进行多因素分析。结果复发组患者术前PSA值（39.2±27.8）μg/L、术前Gleason评分（7.26±1.13）、术后Gleason评分（7.14±1.10）、手术切缘阳性率（20.5%）、包膜侵犯阳性率（21.1%）、精囊侵犯阳性率（19.5%）、淋巴结转移阳性率（20.5%）显著高于非复发组[（31.4±27.2）、（6.81±1.31）、（6.89±1.26）、（8.3%）、（9.0%）、（8.3%）和（7.6%）,P〈0.05]。两组患者在临床分期、病理分期方面有显著差异（P〈0.05）。Cox回归分析结果显示：术前PSA值、术前Gleason评分、病理分期、精囊侵犯和淋巴结转移是RP后BCR的主要危险因素（P〈0.05）。结论术前PSA、术前Gleason评分、病理分期、精囊侵犯和淋巴结转移是RP后BCR的主要危险因素。Objective To analyze the risk factors for biochemical recurrence（BCR） after radical prostatectomy（RP）.Methods Clinical and follow-up data of 486 patients with prostate cancer who received RP from January 2006 to December 2014 were retrospectively analyzed. Relevant parameters of patients before the surgery, during the surgery, after the surgery and during follow-up were recorded. The patients were assigned to the recurrence group and non-recurrence group according to wether BCR occurred after the surgery. The differences of relevant parameters were compared between the two groups of patients, and multi-variate analysis was performed by Cox regression model. Results In the patients in recurrence group, PSA value before the surgery was（ 39. 2 ± 27. 8）, Gleason score before the surgery was（7.26±1.13）, Gleason score after the surgery was（7.14±1.10）, positive rate of surgical cutting margin was 20.5%, positive rate of capsular invasion was 21.1%, positive rate of seminal vesicle invasion was 19.5%,and positive rate of lymph node metastasis was 20.5%, all higher than those of（31.4 ±27.2）,（6.81 ±1.31）,（6.89 ±1.26）,（8.3%）,（9.0%）,（8.3%） and（7.6%） in the non-recurrence group（P 0.05）. There were significant differences between the two groups in terms of clinical staging and pathological staging（P〈0.05）. The results of Cox regression analysis showed that： PSA before the surgery（P〈0.0001）, Gleason score before the surgery（P=0.018）, pathological staging（P =0.012）, seminal vesicle invasion（P =0.025） and lymph node metastasis（P =0.019） were main risk factors for BCR after RP（P〈0.05）. Conclusion PSA before the surgery, Gleason score before the surgery, pathological staging,seminal vesicle invasion and lymph node metastasis are main risk factors for BCR after RP.

关 键 词：前列腺肿瘤 根治性前列腺癌切除术 生化复发 危险因素 

分 类 号：R737.25[医药卫生—肿瘤]