腹腔镜及机器人前列腺根治性切除术后病理切缘阳性的影响因素分析  

Analysis of influencing factors of positive pathological margins after laparoscopic and robotic radical prostate resection

作　　者：王社举 闫亮[1] 许鹏[1] 廖志远 Wang Sheju;Yan Liang;Xu Peng;Liao Zhiyuan(Department of Urology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,郑州450052

出　　处：《河南外科学杂志》2024年第3期24-27,共4页Henan Journal of Surgery

摘　　要：目的探讨腹腔镜及机器人影响前列腺根治术(RP)后病理切缘阳性的危险因素。方法回顾性收集郑州大学第一附属医院泌尿外科2021-01—2022-12行腹腔镜或机器人RP术的83例患者的临床资料,其中病理阳性切缘32例,病理阴性切缘51例。运用单因素分析及二元Logistic回归分析影响RP术后病理切缘阳性的相关因素。结果穿刺前总前列腺特异性抗原(TPSA)数值、穿刺针数阳性比、术前穿刺Gleason评分、RP术后Gleason评分、临床T分期的卡方值分别为6.367、26.391、6.893、8.850、23.756,P均<0.05,二元Logistic回归分析显示:临床T分期≥T_(2c)、穿刺前TPSA数值及穿刺针数阳性百分比为影响RP术后病理切缘阳性的独立危险因素(P值分别为:0.029、0.038、0.012,OR均>1)。结论临床T分期≥T_(2c)、穿刺前TPSA数值及穿刺针数阳性百分比是影响腹腔镜及机器人RP术后病理切缘阳性的独立危险因素。Objective To investigate the risk factors affecting positive pathologic margins after radical prostatectomy(RP).Methods The clinical data of 83 patients who underwent laparoscopic or robotic RP in the Department of Urology of the First Affiliated Hospital of Zhengzhou University from 2021-01 to 2022-12 were retrospectively collected,including 32 patients with positive pathologic margins and 51 patients with pathologic negative margins.Univariate analysis and binary Logistic regression were used to analyze the relevant factors affecting positive pathologic margins after laparoscopic or robotic RP.Results The chi-square values of pre-puncture total prostate-specific antigen(TPSA)value,percentage of positive puncture needle count,preoperative puncture Gleason score,post-RP Gleason score,and clinical T stage were 6.367,26.391,6.893,8.850,and 23.756,respectively,with P<0.05,and the binary Logistic regression analysis showed that the clinical T stage≥T_(2c),the value of TPSA before puncture and the percentage of positive puncture needles were independent risk factors affecting the positivity of pathologic margins after RP(P values:0.029,0.038,0.012,OR>1,respectively).Conclusion Clinical T-stage≥T_(2c),pre-puncture TPSA values and percentage of positive puncture needle counts were independent risk factors and positively correlated to positive pathologic margins after RP.

关 键 词：腹腔镜及机器人前列腺根治术 前列腺癌 切缘阳性 

分 类 号：R737.25[医药卫生—肿瘤]