前列腺穿刺单针阳性的临床特点  

Clinical characteristics and prognosis of single positive core prostate cancer

作　　者：陈小豹 张潮鸿 江玮[1] 蔡伟忠[1] 李永生[1] 郑松[1] Chen Xiaobao;Zhang Chaohong;Jiang Wei;Cai Weizhong;Li Yongsheng;Zheng Song(department of urology, Fujian medical university union hospital)

机构地区：[1]福建医科大学附属协和医院

出　　处：《中国男科学杂志》2019年第3期30-33,共4页Chinese Journal of Andrology

摘　　要：目的通过对前列腺穿刺单针阳性并行腹腔镜前列腺癌根治术患者的临床资料进行分析,了解其临床特点及意义。方法收集我院2013年1月至2017年12月进行的1091例前列腺穿刺中穿刺单针阳性确诊为前列腺癌并行腹腔镜前列腺癌根治术的44例患者的临床、病理及随访资料进行分析,并对Gleason评分升级的相关因素进行分析。结果44例单针穿刺阳性前列腺癌的根治标本中,以前列腺根治标本Gleason为标准,穿刺标本Gleason与其一致的有25例(56.8%),评分升高的有17例(3&6%),评分降低的有2例(4.5%),手术切缘阳性13例(29.5%);统计分析显示患者年龄、PSA、fPSA/TPSA、PSAD、前列腺体积与前列腺根治术后Gleason评分升级无明显相关。术后行内分泌治疗者均未发现生化复发,其余患者术后PSA均未升高。结论前列腺单针穿刺阳性者Gleason评分以低危为主,但根治术后Gleason评分升高的风险较高,肿瘤负荷存在被低估的可能,需引起临床重视,目前尚无有效的指标用于预测Gleason评分升级。Objective To evaluate clinical implications of single positive core prostate cancer through clinical data analysis. Methods The clinical data of 44 patients with single positive core prostate cancer performed laparoscopic radical prostatectomy from Jan 2013 to Dec 2017 were analyzed. The influence of patients’ age、PSA level、f/T and prostate volume on Gleason score upgrade were analyzed. Results in 44 patients, Gleason score upgrade were 17(38.6%), Gleason score downgrade were 2(4.5%), Positive surgery margin were 13(29.5%), Statistic analysis shows that patients’ age、PSA、f PSA/TPSA 、PSAD and prostate volume were no associated with Gleason score upgrade. Besides, no biochemical recurrence were found along with follow-up. Conclusion Patients with single positive prostate cancer were mainly in low-risk, however, the risk of Gleason score upgrade was approximately one-third, thus, the risk of underestimation of tumor load should be informed. Besides, no foremost predictors of Gleason score upgrade were found.

关 键 词：前列腺肿瘤 肿瘤分级 活组织检査 针吸 

分 类 号：R737.25[医药卫生—肿瘤]