论文部分内容阅读
目的:分析前列腺癌根治术后病理得分较穿刺得分增加的原因,并建立一个可以预测中国人群中前列腺癌根治术后病理升级的模型。方法:以2008年8月至2013年12月在我院泌尿科行前列腺癌根治性切除术的264例患者的临床资料为基础,根据术前和术后患者病理得分的变化将其分为升级组和未升级组。运用单因素和多因素logistic回归分析病理升级的原因,并通过多因素回归系数建立预测病理升级的诺模图。结果:264例患者中,共238例最终纳入统计分析,多因素logistic回归分析显示前列腺特异抗原密度(0R=3.854,P=0.001)和穿刺Gleason(≤6)评分是中国人群中前列腺癌根治术后病理升级的独立危险因素。前列腺特异抗原密度和穿刺得分的ROC最佳截断取值为0.37 ng/ml 2和8分。运用上述两个变量建立了一个可用于预测病理升级的诺模图。结论:前列腺特异抗原密度和穿刺Gleason评分是预测中国人群中前列腺癌根治术后病理升级的独立危险因素,本研究所得的诺模图可以很好地预测前列腺癌根治术后的病理升级。
OBJECTIVE: To analyze the reasons for the increased pathological score after prostatic cancer surgery compared with pricking score and to establish a model that can predict the pathological upgrade after radical prostatectomy in Chinese population. Methods: Based on the clinical data of 264 patients who underwent radical resection of prostate cancer in our hospital from August 2008 to December 2013, the patients were divided into two groups based on the changes of pathological score before and after surgery Group and not upgraded group. Univariate and multivariate logistic regression analysis was used to analyze the causes of pathological changes and the nomogram was constructed to predict the pathological changes by multivariate regression coefficients. Results: Of the 264 patients, 238 patients were finally included in the statistical analysis. Multivariate logistic regression analysis showed that prostate-specific antigen density (0R = 3.854, P = 0.001) and Gleason puncture (≤6) Post-pathological upgrade independent risk factors. The optimal ROC cut-off for prostate-specific antigen density and puncture score was 0.37 ng / ml at 2 and 8 points. Using these two variables, a nomogram that can be used to predict pathological changes is constructed. CONCLUSIONS: Prostatic specific antigen density and Gleason score are independent risk factors for pathological changes after radical prostatectomy in Chinese population. The nomogram obtained in this study is a good predictor of pathological changes after radical prostatectomy.