50岁以下年轻前列腺癌患者的临床特征及预后分析  

Clinical characteristics and prognosis of patients with prostate cancer under 50 years of age

作　　者：张璐[1] 周亚敏[2] 张凡[1] 刘涛[2] 

机构地区：[1]武汉市第六医院泌尿外科,湖北武汉430015 [2]武汉市第六医院重症监护病房,湖北武汉430015

出　　处：《现代泌尿外科杂志》2018年第3期200-204,共5页Journal of Modern Urology

摘　　要：目的探讨50岁以下年轻前列腺癌(PCa)患者的临床特征及预后,为提高年轻PCa的诊治水平提供理论依据。方法采用回顾性分析2004年1-12月我院收治的192例PCa患者的临床资料,根据其资料结果比较<50岁和≥50岁PCa患者间的临床特点,采用Cox回归模型探讨影响PCa患者预后的相关因素。结果 192例PCa患者中<50岁者占26%(18/192)。<50岁PCa患者较≥50岁者而言,其总前列腺特异性抗原(TPSA)水平更高[(22.36±4.32)ng/mL vs.(18.48±2.68)ng/mL],尿路症状IPSS评分较低[(8.32±2.46)分vs.(11.24±3.46)分],且前者肿瘤低分化更多(53.85%vs.20.48%),更容易发生骨转移(69.23%vs.38.55%)、淋巴结转移(34.62%vs.16.87%)和肝转移(38.46%vs.10.84%)(P<0.05)。<50岁者中位生存期为24个月,出院后1年、3年和5年生存率分别为53.85%、50.00%和30.77%;≥50岁者中位生存期为28个月,出院后1年、3年和5年生存率分别为72.29%、56.02%和37.50%。多元Cox回归分析显示50岁以下(HR=1.83,95%CI:1.05~3.16)为PCa患者预后危险因素之一。结论 50岁以下PCa患者其肿瘤恶性程度更高,更易发生骨转移、淋巴结转移和肝转移,且年龄、临床分期、血清TPSA水平和治疗方式以及伴有淋巴结转移均为影响PCa患者预后的独立危险因素。Objective To investigate the clinical characteristics and prognosis of patients with prostate cancer （PCa） under 50 years of age.Methods The clinical data of 192 PCa patients treated in our hospital during Jan.2004 and Dec.2014 were retrospectively analyzed.The patients were divided into two groups,under 50-year old group （n=18,young group） and over 50-year old group （n=174,old group）.The clinical characteristics were compared between the two groups.The factors related to the prognosis were investigated with Cox regression model.Results Compared with the old group,the young group had higher total prostate specific antigen （TPSA） [（22.36±4.32） mL vs. （18.48±2.68） mL],lower IPSS score of urinary tract symptoms [（8.32±2.46） min vs.（11.24±3.46） min],poorer tumor differentiation （53.85% vs. 20.48%）,more bone metastases （69.23% vs. 38.55%）,more lymph node metastasis （34.62% vs. 16.87%） and more liver metastasis （38.46% vs. 10.84%） （all P〈0.05）.The median survival,1-year,3-year and 5-year survival rate of the young and old group were 24 vs. 28 months,53.85% vs. 72.29%,50.00% vs. 56.02%,and 30.77% vs. 37.50%,respectively.Multivariate Cox regression analysis showed that age ≤50 （HR=1.83,95%CI：1.05-3.16） was one of the prognostic risk factors for patients with PCa.Conclusion The PCa patients under 50 years of age are more prone to bone,lymph node and liver metastasis,with high malignancy.The age,clinical stage,serum TPSA level,treatment and lymph node metastasis are independent prognostic factors.

关 键 词：50岁以下 前列腺癌 临床特征 预后分析 影响因素 

分 类 号：R737.25[医药卫生—肿瘤]