湖南地区前列腺癌流行病学及临床病理特征分析  

Epidemiological and clinicopathological characteristics of prostate cancer in Hunan

作　　者：邹博 龙衍 杨智明 高瑞松 林群芳[3] 戴新军 易港 王钦正 周青[3] 张晓波[2] ZOU Bo;LONG Yan;YANG Zhi-ming;GAO Rui-song;LIN Qun-fang;DAI Xin-jun;YI Gang;WANG Qin-zheng;ZHOU Qing;ZHANG Xiao-bo(Graduate School,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Department of Urology,Xiangya Hospital of Central South University,Changsha,Hunan 410008,China;Department of Andrology,The First Afiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410021,China)

机构地区：[1]湖南中医药大学研究生院,湖南长沙410208 [2]中南大学湘雅医院泌尿外科,湖南长沙410008 [3]湖南中医药大学第一附属医院男科,湖南长沙410021

出　　处：《中华男科学杂志》2022年第9期786-791,共6页National Journal of Andrology

基　　金：国家自然科学基金区域联合创新项目(U20A20408);湖南省中医药管理局重点项目(2021021);湖南省自然科学基金青年项目(2021JJ40420);湖南中医药大学校级科研基金(2020XJJJ037);湖南中医药大学“一方”研究生创新项目(2022YF09)。

摘　　要：目的:本研究通过调查1594例前列腺癌患者流行病学及临床病理特征,为临床防治前列腺癌提供策略。方法:以2010年1月1日至2020年12月31日于中南大学湘雅医院行前列腺穿刺或根治性前列腺切除术后病理确诊为前列腺癌的患者为研究对象,通过病历系统检索患者基本信息、初次就诊主诉以及临床病理结果,统计分析前列腺癌患者流行病学及临床病理数据。结果:前列腺癌患者年龄分布于28~93岁,且前列腺癌患病人数在2010~2020年整体呈上升趋势。首发症状以泌尿系统症状最为多见(62.53%),其次分别为体检发现PSA升高(17.82%),体检发现前列腺癌、前列腺结节、前列腺肿物(8.43%),骨转移症状(2.94%),且2010~2020年因体检发现PSA升高就诊患者逐年增加。前列腺癌患者的Gleason评分以7分占比最多,病理分型以腺癌为主(78.6%)。Logistic回归分析结果显示高Gleason评分是导管内癌发生的独立危险因素,而患者年龄和病检组织Ki67、AR和ERG的表达不做为导管内癌的危险因素出现。结论:前列腺癌发病人数呈现增长趋势,发病人群年龄以50岁以上多见,我国PSA筛查逐渐普及。导管内癌作为侵袭性前列腺癌及不良预后的主要危险因素与高Gleason评分具有显著的相关性。Objective:To investigate the epidemiological and clinicopathological characteristics of PCa and provide some strategies for the clinical prevention and treatment of the malignancy.Methods:This study included 1594 cases of pathologically diagnosed PCa after radical prostatectomy in Xiangya Hospital of Central South University from January 1,2010 to December 31,2020.We collected the basic information about the patients,their main complaints and clinicopathological results,and analyzed the epidemiological and clinicopathological data.Results:The patients were aged from 28 to 93 years,and the number of PCa cases showed an overall upward trend from 2010 to 2020.Urinary system symptoms were most common(62.53%)as initial symptoms,followed by increased PSA(17.82%),PCa,prostate nodule,prostate mass(8.43%)and bone metastasis(2.94%)found at physical examinations,and the cases of PSA elevation among the clinic visitors increased year by year from 2010 to 2020.Gleason score 7 was found in a largest proportion of the PCa patients,and adenocarcinoma was the main pathological type(78.6%).Logistic regression analysis showed that high Gleason score,instead of age and expressions of Ki67,AR and ERG,was an independent risk factor for intraductal carcinoma.Conclusion:The incidence of PCa shows an increasing trend,and is more common in those over 50 years old.PSA screening is gradually popularized in China.Intraductal carcinoma,as a major risk factor for aggressive PCa and poor prognosis of the malignancy,is significantly correlated with high Gleason scores.

关 键 词：前列腺癌 流行病学 病理特征 GLEASON评分 导管内癌 

分 类 号：R737.25[医药卫生—肿瘤]