ELRP与开放术治疗前列腺癌的效果对比及血清PSMA、FPSAR的差异性表达  

Comparison of effect on ELRP and open prostatectomy in the treatment of prostate cancer and the differential expression of serum PSMA and FPSAR

作　　者：武旻[1] 鲁静 董争争 Wu Min;Lu Jing;Dong Zhengzheng(Department of Urology,Ordos City Central Hospital Ordos,Ordos O17000,China)

机构地区：[1]鄂尔多斯市中心医院泌尿外科,鄂尔多斯017000

出　　处：《国际泌尿系统杂志》2022年第6期976-980,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨经腹膜外入路前列腺根治性切除术(ELRP)与开放术治疗前列腺癌的效果对比及血清前列腺特异性膜抗原(PSMA)、游离前列腺特异抗原百分率(FPSAR)的差异性表达。方法回顾性分析2016年1月至2021年1月本院收治的62例前列腺癌患者的临床资料,按术式的不同分为研究组(36例,行ELRP术)和对照组(26例,行传统开放手术)。比较两组患者的围手术期情况,包括手术时间、术中出血量、住院时间、术后通气时间、尿管拔除时间。对比分析两组患者的术后并发症发生率。采用国际前列腺癌生活质量评分标准对两组患者的生活质量进行评估。记录两组患者术后1年的尿失禁发生率。采用酶联免疫吸附测定(ELISA)法检测患者PSMA水平,采用化学发光分析法测定总前列腺特异抗原(tPSA)、游离前列腺特异抗原(fPSA)水平,计算FPSAR(fPSA/tPSA)。结果研究组的手术时间、术中出血量、住院时间、术后通气时间、尿管拔除时间均短于对照组(均P<0.001);研究组的术后并发症发生率低于对照组[11.11%(4/36)vs.34.62%(9/26),P<0.05];研究组术后1个月、术后6个月的生活质量评分高于对照组(P<0.05),且两组术后1个月、术后6个月的生活质量评分均高于术前(均P<0.05);研究组的术后1年尿失禁发生率为2.78%(1/36),低于对照组的11.54%(3/26)(P<0.05);两组术后1周的血清PSMA低于术前,血清FPSAR水平高于术前(均P<0.05),但两组术后1周的血清PSMA、FPSAR水平比较,差异均无统计学意义(均P>0.05)。结论与开放术比较,ELRP术可改善围手术期情况,降低术后并发症发生率和尿失禁发生率,提高患者的生活质量,并且对术后患者的血清PSMA、FPSAR水平产生影响。Objective To investigate the effect of extraperitoneal laparoscopic radical prostatectomy(ELRP)and open surgery in the treatment of prostate cancer,and the differential expression of prostate specific membrane antigen(PSMA)and free prostate specific antigen(FPSAR)in serum.Methods The clinical data of 62 patients with prostate cancer admitted to our hospital from January 2016 to January 2021 were retrospectively analyzed.According to different surgical methods,they were divided into study group(36 cases underwent ELRP)and control group(26 cases underwent traditional open surgery).The perioperative conditions of the two groups were compared,including operation time,intraoperative blood loss,hospital stay,postoperative ventilation time,and catheter removal time.The incidence of postoperative complications was compared between the two groups.International Prostate Cancer Quality of Life Score was used to evaluate the quality of life of the two groups.The incidence of urinary incontinence 1 year after operation was recorded in the two groups.The levels of PSMA were detected by enzyme-linked immunosorbent assay(ELISA).The levels of total prostate specific antigen(tPSA)and free prostate specific antigen(fPSA)were determined by chemiluminescence analysis.FPSAR(fPSA/tPSA)was calculated.Results The operation time,intraoperative blood loss,hospital stay,postoperative ventilation time and catheter removal time in the study group were shorter than those in the control group(all P<0.001).The incidence of postoperative complications in the study group was 11.11%(4/36)lower than that in the control group 34.62%(9/26)(P<0.05);The quality of life scores of the study group at 1 month and 6 months after operation were higher than those of the control group(P<0.05),and the quality of life scores of the two groups at 1 month and 6 months after operation were higher than those before operation(P<0.05).The incidence of urinary incontinence in the study group was 2.78%(1/36),which was lower than 11.54%(3/26)in the control group(P<0.05).T

关 键 词：前列腺肿瘤 前列腺切除术 腹膜外途径 开放手术 

分 类 号：R737.25[医药卫生—肿瘤]