代谢综合征与前列腺癌根治术后病理特征的相关性研究  

The association between metabolic syndrome and pathological features in radical prostatectomy

作　　者：郭耀川 陈鹏[1,2] 曹德宏 黄煜[1] 魏强[1] 

机构地区：[1]四川大学华西医院泌尿外科/四川大学华西医院泌尿外科研究所,四川成都610041 [2]贵州医科大学附属医院泌尿外科,4贵州贵阳255000

出　　处：《国际泌尿系统杂志》2018年第1期7-11,共5页International Journal of Urology and Nephrology

基　　金：四川省卫生厅项目（150117）

摘　　要：目的 探讨行前列腺癌根治术的患者中代谢综合征与前列腺癌分期、分级的关系.方法 回顾性收集2009年1月至2016年7月于华西医院行前列腺癌根治术患者的临床资料,分为代谢综合征组与非代谢综合征组,比较两组临床资料特点,探究代谢综合征与前列腺癌分期、分级的关系.结果 纳入的499例前列腺癌根治术患者中,93例（18.6％）符合代谢综合征诊断标准.代谢综合征组肿瘤前列腺外浸润（pT3 ～4）的风险是非代谢综合组的2.2倍（OR=2.222,95％ CI：1.349 ～3.661,P=0.0002）,Gleason评分≥8分风险达到3倍（OR =3.061,95％ CI：1.313～7.137,P=0.010）.合并肥胖的前列腺患者肿瘤前列腺外浸润和Gleason评分≥8分风险分别是非肥胖患者的2倍（OR =2.000,95％ CI：1.279～3.128,P=0.002）和2.4倍（OR=2.436,95％ CI：1.068 ～5.555,P=0.034）.合并代谢综合征组分数量达到3个以上时,肿瘤前列腺外浸润的风险增加94％（OR=1.941,95％ CI：1.093～3.449,P=0.024）,Gleason评分≥8分的风险是无代谢综合组分患者的4.3倍（OR =4.316,95％ CI：1.530 ~12.174,P=0.006）.结论 代谢综合征与肿瘤前列腺外浸润和Gleason评分≥8分显著相关.肥胖与前列腺癌分期、分级正相关,只有当代谢综合征组分累积到代谢综合征状态时才导致高危前列腺癌的风险增加.Objective To investigate the association between metabolic syndrome and pathological features in radical prostatectomy.Methods All the clinical data of radical prostatectomy in our hospital from January 2009 to July 2016 were collected retrospectively.All patients were divided into metabolic syndrome group and not metabolic syndrome group.Results Of 499 patients,93 （18.6％） patiens had metabolic syndrome.Compared with no metabolic syndrome group,the patients with metabolic syndrome suffered a 2.2-fold risk （OR =2.222,95 ％ CI：1.349 ～ 3.661,P =0.0002） of extraprostatic cancer and 3-fold risk （OR =3.061,95 ％ CI：1.313 ～ 7.137,P =0.010） of Gleason score≥8.Patients with obesity suffered 2-fold risk（OR =2.000,95％ CI：1.279 ～ 3.128,P =0.002） of extraprostatic cancer and 2.4-fold risk（OR =2.436,95％ CI：1.068 ～ 5.555,P =0.034） of high-risk Gleason score disease,meanwhile high blood pressure,hyperlipidaemia and hyperglycemia were not associated with more adverse prostate cancer.The risk of extraprostatic cancer increased 94％ （OR =1.941,95％ CI：1.093 ～ 3.449,P =0.024） when patients had three or more components,who would suffer 4.3-fold risk （OR =4.316,95 ％ CI：1.530 ～ 12.174,P =0.006） of Gleason score ≥8.Conclusions Metabolic syndrome is significantly associated with extraprostatic cancer and Gleason score≥8.Obesity can predict extraprostatic cancer and Gleason score≥8.In addition,only three or more components coexisting in one patient will increase the risk of extraprostatic cancer and Gleason score ≥ 8.

关 键 词：前列腺肿瘤 代谢综合征X 

分 类 号：R737.25[医药卫生—肿瘤]