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背景与目的:前列腺癌存在种族差异,本文探讨新疆不同民族前列腺癌患者内分泌治疗的预后及影响因素,旨在了解种族差异与前列腺癌预后的关系。方法:回顾性分析228例接受内分泌治疗的前列腺癌患者的临床病理资料,应用Kaplan-Meier法计算生存率,对可能影响患者预后的因素分别进行单因素分析(log-rank检验),应用Cox比例风险模型进行多因素统计分析。结果:228例患者1、3和5年疾病特异性生存率分别为93.2%、68.3%和40.1%;汉族和其他少数民族(维吾尔、哈萨克)患者内分泌治疗的3年疾病特异性生存率分别为73.6%和54.2%(P=0.025);不同内分泌治疗组的3年疾病特异性生存率分别为:最大限度雄激素阻断治疗(maximal androgen blockade,MAB)72.2%、单纯去势或单纯抗雄激素药物治疗组56.3%(P=0.004)。单因素分析的结果显示,患者民族、治疗前ECOG体力状况(EPS)评分、临床分期、Gleason评分、治疗前总前列腺特异抗原(total prostate specific antigen,tPSA)、血清碱性磷酸酶(alkaline phosphatase,ALP)、血红蛋白(hemoglobin,HGB)水平以及MAB治疗均对前列腺癌的生存预后产生重要的影响。多因素分析结果显示,患者民族、治疗前EPS评分、临床分期、Gleason评分、HGB及MAB治疗是影响前列腺癌患者存活的重要因素。结论:接受MAB治疗的患者比单纯去势或抗雄激素治疗生存率高;影响前列腺癌内分泌治疗的预后因素中,民族、临床分期、Gleason评分、治疗前HGB水平、EPS评分及MAB治疗都是重要的独立因素。
BACKGROUND & OBJECTIVE: There are racial differences in prostate cancer. This article explored the prognosis and influencing factors of endocrine therapy in patients with prostate cancer of different nationalities in Xinjiang in order to understand the relationship between racial differences and the prognosis of prostate cancer. Methods: The clinical and pathological data of 228 patients with endocrine-treated prostate cancer were retrospectively analyzed. Kaplan-Meier method was used to calculate the survival rate. Univariate analysis (log-rank test) was performed on the factors that may affect the prognosis of patients. Risk model for multi-factor statistical analysis. Results: The disease-specific survival rates at 1, 3, and 5 years were 93.2%, 68.3% and 40.1% respectively in 228 patients. The 3-year disease-specific survival rates of endocrine therapy in Han and other ethnic groups (Uyghur, Kazak) 73.6% and 54.2% respectively (P = 0.025). The 3-year disease-specific survival rates of different endocrine therapy groups were: maximal androgen blockade (MAB) 72.2%, simple castrated or simple anti-male Hormone drug treatment group 56.3% (P = 0.004). The results of univariate analysis showed that there were significant differences in the nationalities, pre-treatment ECOG scores, clinical stage, Gleason score, total prostate specific antigen (tPSA), alkaline phosphatase ALP, hemoglobin (HGB) levels and MAB treatment have a significant impact on the prognosis of prostate cancer. Multivariate analysis showed that patient ethnicity, pre-treatment EPS score, clinical stage, Gleason score, HGB and MAB treatment were the important factors affecting the survival of patients with prostate cancer. Conclusions: The survival rate of MAB-treated patients is higher than that of castrate alone or anti-androgen therapy. Among the prognostic factors that influence the endocrine therapy of prostate cancer, ethnicity, clinical stage, Gleason score, pre-treatment HGB level, EPS score and MAB treatment are all Important independent factor.