基于潜在类别分析的不同PSA水平前列腺癌患者术后生化复发影响因素分布  

Distribution of influencing factors of postoperative biochemical recurrence in prostate cancer patients with different PSA levels based on latent class analysis

作　　者：田超[1] 曹正国[1] 韩庆杰 王航涛 张朝胜[1] 蒋茂林[1] 黎建欣[1] TIAN Chao;CAO Zhengguo;HAN Qingjie;WANG Hangtao;ZHANG Chaosheng;JIANG Maolin;LI Jianxin(Department of Urology,North Guangdong People's Hospital,Shaoguan,Guangdong,512026,China)

机构地区：[1]粤北人民医院泌尿外二科,广东韶关512026

出　　处：《临床泌尿外科杂志》2022年第7期537-542,共6页Journal of Clinical Urology

摘　　要：目的:探讨基于潜在类别分析的不同前列腺特异性抗原(PSA)水平前列腺癌(PCa)患者术后生化复发影响因素分布特征。方法:选择2016年10月-2021年11月于粤北人民医院收治的155例PCa患者为研究对象。将纳入患者按照术后是否生化复发,分为复发组(43例)和非复发组(112例)。比较两组临床资料,采用多因素logistic回归模型分析患者术后生化复发的影响因素。使用潜在类别分析法比较高风险与低风险间的分布特征差异。结果:术前Gleason评分、术后Gleason评分、精囊侵犯、淋巴结侵犯、切缘阳性、术前PSA水平均为患者生化复发的独立危险因素(P<0.05),且6个影响因素的分布具有明显差异。聚类分析结果将研究对象分为复发高风险组(PSA≥20μg/L,20例,复发发生率12.90%)和复发低风险组(PSA<20μg/L,23例,复发发生率14.84%)。潜在类别结果显示,高风险组的2个潜在类别的概率为46.02%、46.45%,低风险组的2个潜在类别的概率为45.00%、45.43%。结论:不同PSA水平的PCa患者术后生化复发情况在术前Gleason评分、术后Gleason评分、精囊侵犯、淋巴结侵犯、切缘阳性、术前PSA水平的因素值得临床深入探究。另外,本文通过潜在类别分析发现,患者术后生化复发的高风险和低风险人群在以上影响因素的分布特征中具有显著差异。Objective: To explore the distribution characteristics of factors influencing postoperative biochemical recurrence in prostate cancer patients with different PSA levels based on latent class analysis. Methods: A total of 155 patients with prostate cancer who were admitted to North Guangdong People’s Hospital from October 2016 to November 2021 were selected as the research subjects. The included patients were divided into recurrence group(n=43) and non-recurrence group(n=112) according to whether there was biochemical recurrence after surgery. The clinical data of the two groups were compared, and the multivariate logistic regression model was used to analyze the influencing factors of postoperative biochemical recurrence. Differences in distribution characteristics between high and low risk were compared using latent class analysis. Results: Preoperative Gleason score, postoperative Gleason score, seminal vesicle invasion, lymph node invasion, positive resection margin, and preoperative PSA level were all independent risk factors for biochemical recurrence(P<0.05), and the distribution of the six influencing factors was significantly different. Cluster analysis results divided the research subjects into a high-risk group(PSA≥20 μg/L, 20 patients, with a recurrence rate of 12.90%) and a low-risk group(PSA<20 μg/L, 23 patients, with a recurrence rate of 14.84%). The latent category results showed that the probabilities of the two latent categories in the high-risk group were 46.02% and 46.45%, and the probabilities of the two latent categories in the low-risk group were 45.00% and 45.43%. Conclusion: The factors of postoperative biochemical recurrence of prostate cancer patients with different PSA levels, including preoperative Gleason score, postoperative Gleason score, seminal vesicle invasion, lymph node invasion, positive resection margin, and preoperative PSA level, are worthy of further clinical investigation. In addition, this paper found that the distribution characteristics of the above influencing f

关 键 词：潜在类别分析 前列腺特异性抗原 前列腺癌 生化复发 影响因素 

分 类 号：R737.25[医药卫生—肿瘤]