晚期前列腺癌多发转移风险预测指标的探讨  

The effects of clinical characteristics on the numbers of metastasis positions in prostate cancer patients

作　　者：张鸿毅[1] 高继学[2] 张培波[2] 郭巍[2] 王振龙[3] 王子明[3] 崔洁[4] 

机构地区：[1]西安医学院第一附属医院泌尿外科,陕西西安710077 [2]延安大学附属医院泌尿外科,陕西延安716000 [3]西安交通大学医学院第二附属医院泌尿外科,陕西西安710004 [4]西安医学院第一附属医院胸外肿瘤科,陕西西安710077

出　　处：《现代肿瘤医学》2017年第11期1743-1746,共4页Journal of Modern Oncology

基　　金：延安市科学技术研究发展计划项目支持(编号:2015KW-06)

摘　　要：目的:探讨年龄、Gleason评分、前列腺体积、治疗前血清PSA水平、雄激素阻断(ADT)后PSA水平、ECOG评分、是否有高血压、糖尿病和病理性骨折对晚期前列腺癌患者单发或多发转移的预测价值。方法:回顾性分析2005年1月至2011年8月收治的198例转移性前列腺癌患者的临床资料,应用χ2检验分析临床因素与转移部位数量的关系;多发转移的影响因素分析应用logistic回归分析;应用Kaplan-Meier法和logrank检验进行生存分析。结果:晚期前列腺癌的Gleason评分8~10分(P<0.001)、ADT后PSA水平>0.2ng/ml(P<0.001)、治疗前血清PSA水平>60 ng/ml(P=0.004)、ECOG评分≥2(P=0.002)和多发转移有显著的相关性;应用二维logistic回归分析研究这些变量对多发转移的影响,结果显示Gleason评分(P=0.022)、治疗前血清PSA水平(P=0.028)、ADT后PSA水平(P<0.001)和ECOG评分(P=0.001)对多发转移有显著影响;转移位置数量≥2个提示生化复发(多发:21个月vs单发:24个月)和生存时间(多发:36个月vs单发:45个月)均较短(P<0.001)。结论:晚期前列腺癌的Gleason评分、治疗前血清PSA水平、ADT后PSA水平和ECOG评分与多发转移有显著正相关性;多发转移预示较短的生化复发和生存时间。Objective：To analyze the effects of clinical characteristics on the numbers of metastasis positions in metastatic prostate cancer patients. Methods ： A total of 198 patients who received androgen deprivation therapy （ADT） from January 2005 to August 2011 were recruited. The relation between the clinical characteristics and the numbers of metastasis positions were analyzed by test and logistic regression model. The effects of the numbers of metastasis positions on prognosis were analyzed by survival analysis with Kaplan - Meier method and log - rank test. Results： There were significant relations between Gleason scores,serum prostate - specific antigen （PSA） levels,PSA levels after ADT,ECOG scores and number of metastatic sites. Compared with single metastasis, the biochemical pro-gression free survival and overall survival were shortened in patients with multiple metastasis. Conclusion ： Gleason scores, serum PSA levels, PSA levels after ADT,ECOG scores have an important effects on number of metastatic sites. The multiple metastasis predicted poor prognosis.

关 键 词：前列腺癌 转移 雄激素阻断 生化复发 

分 类 号：R737.2[医药卫生—肿瘤]