移行带与外周带前列腺癌的临床病理特征比较与预后评估  

Comparison of clinicopathological characteristics and prognostic evaluation of prostate cancers between peripheral zone and transition zone

作　　者：仲津漫 丁健科 车志文 杨全新[1] ZHONG Jinman;DING Jianke;CHE Zhiwen;YANG Quanxin(Department of Radiology,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004;Department of Plastic Surgery,Xijing Hospital,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]西安交通大学第二附属医院医学影像科,陕西西安710004 [2]空军军医大学第一附属医院整形外科,陕西西安710032

出　　处：《西安交通大学学报（医学版）》2024年第6期988-992,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发计划资助项目(No.2024SF-YBXM-417);西安交通大学第二附属医院科研基金资助项目[No.YJ(QN)202313]。

摘　　要：目的 分析不同区带起源的前列腺癌的相关临床病理特征,评估根治术后各区带起源前列腺癌的预后。方法 回顾性收集2016年2月至2021年8月西安交通大学第二附属医院经穿刺活检及根治性前列腺切除术的局灶性前列腺癌患者,据癌灶所在区带分为外周带前列腺癌组和移行带前列腺癌组,术后定期随访。采用非配对t检验、卡方检验及Mann-Whitney U检验分别比较两组间患者年龄、前列腺特异性抗原(prostate specific antigen, PSA)水平、肿瘤体积、Gleason评分、阳性穿刺条数单侧性比率、阳性穿刺条数百分比、临床/病理分期、精囊腺侵犯率、淋巴结转移率、手术切缘阳性率等临床病理特征;用Kaplan-Meier生存分析评估两组术后无生化复发生存率;对数秩检验比较两组间无生化复发生存率的差异。结果 纳入符合条件的273例前列腺癌患者,其中外周带前列腺癌176例,移行带前列腺癌97例。移行带组的肿瘤体积明显大于外周带组(P=0.002),术前血清PSA水平亦显著高于外周带组(P=0.047),但前者的阳性穿刺条数百分比、精囊侵犯率均低于后者(P=0.028、0.047)。两组患者的无生化复发生存率之间无统计学差异(P=0.783)。结论 与外周带前列腺癌相比,尽管移行带前列腺癌瘤灶较大、血清PSA水平较高,但无生化复发生存率与前者类似,移行带前列腺癌较外周带前列腺癌的侵袭性低。Objective To compare the clinicopathological characteristics of localized prostate cancers between peripheral zone and transition zone and to evaluate biochemical recurrence-free survival rates between the two groups following radical prostatectomy.Methods Between February 2016 and August 2021,prostate cancer candidates meeting the eligibility criteria of the study were retrospectively enrolled and divided into transition zone group and peripheral zone group based on the zonal origin.The patients were followed regularly after radical prostatectomy.Unpaired t-test,χ^(2)-test and Mann-Whitney U-test were used to compare age,serum prostate specific antigen(PSA),tumor volume,Gleason score,laterality of positive biopsy core,mean percentage of positive biopsy cores,clinical/pathological stage,seminal vesicle invasion,lymph node metastasis,and positive surgical margin between the two groups.The biochemical recurrence-free survival rates of the two groups were evaluated by Kaplan-Meier and the differences were determined by log-rank test.Results A total of 273 cases were included in the study,among which 176 were peripheral zone cancers and 97 were transition zone cancers.The mean tumor volume of the transition zone group was greater than that of peripheral zone group(P=0.002).The serum PSA of transition zone group was higher than that of the latter(P=0.047);however,both mean percentage of positive biopsy cores and the percentage of seminal vesicle invasion were higher in transition zone group than in peripheral zone group(P=0.028,0.047).Furthermore,there was no significant difference in biochemical recurrence-free survival rate between the two groups(P=0.783).Conclusion Despite the greater tumor volume and higher PSA compared with those in peripheral zone cancers,transition zone cancers have similar biochemical recurrence-free survival rates following radical prostatectomy,suggesting that transition zone cancers may have a lower degree of aggressiveness than the latter.

关 键 词：移行带前列腺癌 外周带前列腺癌 根治性前列腺切除术 无生化复发生存率 

分 类 号：R445[医药卫生—影像医学与核医学]