肥胖与前列腺癌根治术后病理特征变化的相关性  

Correlation between obesity and pathological changes after radical prostatectomy

作　　者：谢英伟 金仕鹏 王永辉 李爽[1] 刘跃新[1] Xie Yingwei;Jing Shipeng;Wang Yonghui;Li Shuang;Liu Yuexin(Department of Urology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院泌尿外科,北京100730

出　　处：《国际泌尿系统杂志》2020年第4期584-587,共4页International Journal of Urology and Nephrology

基　　金：北京市自然科学基金(7102033)。

摘　　要：目的探讨肥胖与前列腺癌根治术(RP)后病理特征变化的相关性。方法回顾性分析2014年1月至2019年1月于本院收治的120例RP患者。收集并分析患者年龄、身高、体质量、前列腺体积、穿刺活检病理结果、术前前列腺特异性抗原(PSA)水平和术后病理结果。根据体质量指数(BMI)将患者分为三组:正常组(18.5 kg/m^2≤BMI<24 kg/m^2)30例、超重组(24 kg/m^2≤BMI<28 kg/m^2)66例、肥胖组(BMI≥28 kg/m^2)24例。结果RP后,肥胖组患者Gleason评分高于其他组,差异具有统计学意义(P<0.01)。48例患者诊断为局部进展期前列腺癌(PCa),其中BMI正常组6例,超重组27例,肥胖组15例,差异有统计学意义(P<0.01)。28例患者出现Gleason评分升级,其中BMI正常组5例,超重组13例,肥胖组10例,差异有统计学意义(P=0.04)。30例患者术后切缘阳性,其中BMI正常组4例,超重组17例,肥胖组9例,差异具有统计学意义(P=0.04)。结论肥胖患者在RP后Gleason评分以及病理分期更高,同时具有较高的切缘阳性率,Gleason评分升级发生率也较高。Objective To investigate the correlation between obesity and pathological changes after radical prostatectomy.Methods A retrospective analysis of 120 patients undergoing radical prostatectomy from January 2014 to January 2019 was performed.The patient's age,height,weight,prostate volume,biopsy pathological results,preoperative PSA levels,and postoperative pathological results were collected.Patients were divided into three groups according to BMI,normal group(18.5 kg/m^2≤BMI<24 kg/m^2),super-recombination(24 kg/m^2≤BMI<28 kg/m^2),obesity group(BMI≥28 kg/m^2).Results This study included 120 patients.There were 30 cases in the normal group,66 cases in the super group,and 24 cases in the obesity group.After radical prostatectomy,the Gleason score was higher in the obesity group than in the other groups(P<0.01).Forty-eight patients were diagnosed as locally advanced prostate cancer,including 6(20.00%)in BMI normal group,27(40.91%)in overweight group and 15(62.50%)in obesity group.The difference was statistically significant(P<0.01).Gleason score was upgraded in 28 patients,including 5(16.67%)in normal BMI group,13(19.70%)in overweight group and 10(41.67%)in obesity group,with significant difference(P=0.04).Postoperative margin was positive in 30 patients,including 4(13.33%)in the normal BMI group,17(22.73%)in the overweight group and 9(37.50%)in the obesity group(P=0.04).Conclusions Patients with obesity have a higher Gleason score and pathological stage after radical prostatectomy,and have a higher rate of positive margin and a higher rate of Gleason score upgrade.

关 键 词：前列腺肿瘤 肥胖 前列腺切除术 

分 类 号：R737.25[医药卫生—肿瘤]