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目的:探讨国人前列腺癌患者前列腺体积与肿瘤分级之间的关系。方法:回顾我院及武汉大学人民医院2005年1月-2011年10月70例确诊为前列腺癌并行根治性前列腺切除术(RP)患者的临床病理资料,采用SPSS13.0软件总结并分析前列腺癌患者前列腺体积与肿瘤分级之间的关系。结果:经直肠前列腺穿刺活检获得肿瘤病理分级与根治性前列切除术获得最终病理分级具有显著差异(P=0.003);在活检及根治性前列腺切除标本中,前列腺体积与高级别肿瘤发生率均呈负相关(P<0.05);小前列腺与阳性手术切缘、前列腺外侵犯及高级别肿瘤在单变量分析中具有相关性(P<0.05),而与精囊腺侵犯及淋巴结侵犯则无相关性(P>0.05);在校正了年龄、体重指数及术前前列腺特异性抗原水平后,前列腺体积与阳性手术切缘、前列腺外侵犯、精囊腺侵犯及高级别肿瘤发生率均呈负相关(OR<1,P<0.05),而与淋巴结侵犯则无相关性(P>0.05)。结论:前列腺体积是高级别前列腺癌的重要预测因子,利用其对高级别肿瘤风险的预测能力可帮助选择最佳治疗方案并进一步提高治疗效果。
Objective: To investigate the relationship between prostate volume and tumor grade in Chinese patients with prostate cancer. Methods: The clinical and pathological data of 70 patients with radical prostatectomy (RP) diagnosed as prostate cancer from January 2005 to October 2011 in our hospital and from People’s Hospital of Wuhan University were retrospectively analyzed. SPSS13.0 software was used to summarize and analyze the clinical data of prostate cancer The relationship between the patient’s prostate volume and tumor grade. Results: There was a significant difference (P = 0.003) between pathological grading and radical prostatectomy in transrectal prostate biopsy. In both biopsy and radical prostatectomy specimens, both the prostate volume and high-grade tumors were significantly (P <0.05). There was a correlation between small prostate and positive surgical margins, extra-prostatic extravasation and high-grade tumors in univariate analysis (P <0.05), but not with invasion of seminal vesicles and invasion of lymph nodes P> 0.05). After adjusting for age, body mass index and the level of preoperative prostate-specific antigen, negative correlation was found between prostate volume and positive surgical margin, extra-prostatic invasion, seminal vesicle invasion and high-grade tumor incidence (OR < 1, P <0.05), but no correlation with lymph node invasion (P> 0.05). Conclusions: Prostate volume is an important predictor of high-grade prostate cancer and its ability to predict high-grade cancer risk can help select the best treatment and further improve the outcome.