前列腺癌患者中两种基准标志物置入方法比较和风险因素分析  

Comparison and Risk Factor Analysis of Two Fiducial Marker Implantation Methods for Patients with Prostate Cancer

作　　者：王素丽 田龙[1] 胡逸民[2] WANG Suli;TIAN Long;HU Yimin(Department of Radiotherapy,the First Affiliated Hospital of Hebei Northern University,Zhangjiakou Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院放疗科,河北张家口075000 [2]中国医学科学院肿瘤医院放疗科

出　　处：《联勤军事医学》2023年第5期405-408,423,共5页Military Medicine of Joint Logistics

基　　金：张家口市重点研发计划项目(1921002B)。

摘　　要：目的比较接受前列腺癌(prostate cancer,PCa)图像引导放疗(image-guided radiotherapy,IGRT)的患者中经直肠超声引导下会阴穿刺法(trans-perineal ultrasound,TPUS)和经直肠超声引导下直肠穿刺法(trans-rectal ultrasound,TRUS)两种基准标志物(fiducial marker,FM)置入方法并进行风险因素分析。方法回顾性分析208例PCa患者的临床资料。根据置入方法分为TPUS组(n=98)和TRUS组(n=110)。比较两种置入方法的观察指标(疼痛、出血、感染情况)。对观察指标行单因素、多因素Logistic逐步回归风险因素分析。结果TPUS组疼痛视觉模拟量表(pain visual analogue score,VAS)评分≥4分、严重出血患者比例显著高于TRUS组(P均<0.05);TPUS组总体感染率低于TRUS组(5.10%vs.8.18%)。体质量指数(body mass index,BMI)是VAS评分升高的独立风险因素,前列腺体积和新辅助雄激素剥夺治疗接受情况(androgen deprivation therapy,ADT)是严重出血比例升高的独立风险因素。结论TPUS法和TRUS法各有利弊,需根据患者自身条件提前做好准备。Objective To compare two fiducial marker(FM)implantation methods of trans-perineal ultrasound(TPUS)and trans-rectal ultrasound(TRUS)in image-guided radiotherapy(IGRT)for patients with prostate cancer(PCa),and to analyze its risk factors.Methods The clinical data of 208 PCa patients was retrospectively analyzed.The patients were divided into TPUS group(n=98)and TRUS group(n=110)according to the method of placement.The observation indexes of pain,bleeding and infection were compared between the two methods.Single factor and multi-factor Logistic stepwise regression risk factor analysis was performed on the observation indexes.Results The proportion of patients with pain visual analogue score(VAS)≥4 and severe bleeding in TPUS group was significantly higher than that in TRUS group(all P<0.05);the overall infection rate in TPUS group was lower than that in TRUS group(5.10%vs.8.18%).Body mass index(BMI)was an independent risk factor for elevation of the VAS score,prostate volume and androgen deprivation therapy(ADT)acceptance was independent risk factor for increasing proportion of severe bleeding.Conclusion TPUS and TRUS had their own advantages and disadvantages,preparation should be made in advance according to patients own condition.

关 键 词：前列腺癌 基准标志物 经直肠超声引导下会阴穿刺法 经直肠超声引导下直肠穿刺法 风险因素分析 

分 类 号：R697.3[医药卫生—泌尿科学] R616[医药卫生—外科学]