论文部分内容阅读
目的:探讨临床低危型前列腺癌根治性切除术后病理升级的危险因素。方法:2007年3月~2012年3月收治经前列腺穿刺活检诊断为前列腺腺癌并行前列腺根治性切除术患者270例,其中临床低危型前列腺癌121例,收集患者确诊时年龄、体质指数(BMI)、前列腺特异性抗原(PSA)、前列腺体积(PV)、穿刺针数、穿刺阳性百分数、临床分期、穿刺Gleason评分等,比较患者术前穿刺病理Gleason评分与术后大体病理Gleason评分,使用单因素和多因素Logistic回归分析评估引起临床低危型前列腺癌根治性切除术后病理升级的危险因素。结果:大体病理与术前穿刺病理Gleason评分一致者72例(59.5%),较术前穿刺病理升级者49例(40.5%),在术后病理升级的单因素分析中患者年龄、BMI、临床分期、穿刺针数、穿刺阳性百分数、穿刺Gleason评分均差异无统计学意义(P>0.05),穿刺前PSA(P=0.046)和前列腺体积(P=0.001)差异有统计学意义,进入多因素分析。多因素Logistic回归分析显示小体积前列腺(P=0.001)是低危型前列腺癌根治性切除术后大体病理升级的独立危险因素,小体积和中等体积前列腺是较大体积前列腺者肿瘤发生病理升级的3.65倍和2.21倍。结论:小体积前列腺是临床低危型前列腺癌术后发生病理升级的独立危险因素,在临床工作中应予以重视。
Objective: To explore the risk factors of pathological upgrade after radical resection of low-risk prostate cancer. Methods: From March 2007 to March 2012, 270 patients undergoing radical prostatectomy for prostatic adenocarcinoma undergoing prostate biopsy were enrolled. Among them, 121 patients were clinically diagnosed as low-risk prostate cancer. The age and body mass index BMI, PSA, Prostate volume (PV), number of puncture needle, percentage of puncture positive, clinical stage and Gleason score of puncture were compared between the preoperative puncture pathological Gleason score and postoperative gross pathological Gleason score Univariate and multivariate logistic regression analysis was used to evaluate the risk factors of pathological changes after radical resection of low-risk prostate cancer. Results: There were 72 cases (59.5%) of gross pathology and preoperative puncture pathological Gleason score, 49 cases (40.5%) compared with the preoperative puncture pathological changes, the age, BMI, clinical There was no significant difference in staging, number of puncturing needle, puncturing positive percentage and puncture Gleason score (P> 0.05), but there was significant difference between pre puncture PSA (P = 0.046) and prostatic volume (P = 0.001) analysis. Multivariate logistic regression analysis showed that small volume of prostate (P = 0.001) was an independent risk factor for general pathological improvement after radical resection of low-risk prostate cancer. Small and medium-volume prostate was the pathological upgrade of tumors of larger volume of prostate 3.65 times and 2.21 times. Conclusion: Small volume prostate is an independent risk factor for postoperative pathological upgrade of low-risk prostate cancer, which should be paid more attention in clinical practice.