转移性前列腺癌(mPCa)患者睾酮水平的控制与疾病进展的相关性研究  

Correlation between concentration of testosterone and disease progression in patients with metastatic prostate cancer (mPCa)

作　　者：马麒[1] 邱瑞莹 李钊 阿不都克尤木·麦麦提依明 摆俊博 安恒庆[1] MA Qi;QIU Rui-ying;LI Zhao;Abudukeyoumu Maimaitiyiming;BAI Jun-bo;AN Heng-qing(The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830054,China;The Public Health College of Xinjiang Medical University,Urumqi,830054,China)

机构地区：[1]新疆医科大学第一附属医院,乌鲁木齐830054 [2]新疆医科大学公共卫生学院,乌鲁木齐830054

出　　处：《新疆医学》2021年第6期622-626,657,共6页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(项目编号:2018D01C167)。

摘　　要：目的研究使用不同剂型戈舍瑞林缓释植入剂控制血清睾酮水平对于转移性前列腺癌(metastatic prostate cancer,mPCa)患者疾病的进展是否存在影响,探寻血清睾酮水平变化情况对疾病进展的影响及预测价值。方法回顾性分析2016年1月到2019年9月期间的共96例在本院行经前列腺穿刺活检确诊为前列腺癌,并通过影像学证实已经出现转移的患者。研究使用戈舍瑞林联合比卡鲁胺方案治疗的患者的血清睾酮水平对疾病进展至去势抵抗性前列腺癌(castration resistant prostate cancer,CRPC)的时间的影响,并对比患者使用戈舍瑞林不同剂量剂型(10.8 mg和3.6 mg)是否对其进展至CRPC阶段的时间存在影响。使用统计软件进行Kaplan-Meier生存分析和COX回归分析。结果戈舍瑞林缓释植入剂一个月型(3.6mg)和三个月型(10.8 mg)对控制患者睾酮水平及控制疾病进展至CRPC时间的差异无统计学意义(P> 0.05)。睾酮最低浓度(nadir testosterone,NT)是影响患者进展至CRPC时间的危险因素。结论戈舍瑞林一个月型(3.6 mg)和三个月型(10.8 mg)对疾病进展至CRPC的时间没有明显差异。mPCa患者进行ADT治疗后,睾酮所达到的最低水平(nadir testosterone,NT)越低、到达最低睾酮浓度时间(time to nadir testosterone,TTNT)越长,患者进展至CRPC的时间越长。患者接受ADT治疗后的NT和TTNT对于预测mPCa患者的预后情况和疾病进展速度有重要价值。Objective To study the correlation between control of serum testosterone concentration and disease progression in patients with metastatic prostate cancer(m PCa)after androgen deprivation therapy(ADT), and to compare the effect of different dosage form of goserelin sustained release implant on controlling disease progression. Methods 96 patients with metastatic prostate cancer diagnosed by puncture biopsy and proved by imaging in our hospital from January 2015 to September 2018 were analyzed retrospectively.The relationship between the level of controlled serum testosterone in the patients received ADT of goserelin combined with bicalutamide and the time from the start of disease to progressing to castrated resistant prostate cancer(CRPC)was analyzed, and the effects of different dosage forms of goserelin(10.8 mg and 3.6 mg)on disease progression to CRPC were compared. Kaplan-Meier survival analysis and COX regression analysis were carried out with R software. Results The nadir testosterone(NT)was a risk factor for the progression to CRPC.There was no significant difference in the time of disease progression to CRPC between different dosage forms of goserelin sustained release implant(3.6 mg and 10.8 mg)combined with bicalutamide(P> 0.05). Conclusion One month goserelin(3.6 mg)and three-month goserelin(10.8 mg)had no significant difference in the time of disease progression to CRPC. After patients were treated with ADT, the lower nadir testosterone is, the longer the time to nadir testosterone,and the longer time of disease progression to CRPC needs. NT and TTNT after ADT are important to predicte the prognosis and disease progression of MPCA patients.

关 键 词：前列腺癌 内分泌治疗 睾酮 CRPC 戈舍瑞林 

分 类 号：R697.3[医药卫生—泌尿科学]