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目的:探讨临床局限性前列腺癌根治性切除术后病理发现包膜侵犯的危险因素。方法:回顾性分析191例经前列腺穿刺活检确诊并临床评估为局限性前列腺癌患者对临床资料,收集患者确诊时年龄、体重指数(BMI)、前列腺特异抗原(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,根据前列腺根治性切除术后病理标本评估包膜侵犯情况,使用单因素和多因素Logistic回归分析临床局限性前列腺癌根治性切除术后病理包膜侵犯的危险因素。结果:191例临床局限性前列腺癌患者行根治性切除术后病理发现包膜侵犯者45例(23.6%),单因素分析显示前列腺体积较小组、穿刺Gleason评分较高组和穿刺阳性百分数较大组术后病理包膜侵犯比例明显增高,多因素Logistic回归分析显示前列腺体积小(P=0.023)和穿刺Gl-eason评分高(P=0.019)是临床局限性前列腺癌根治性切除术后发现病理包膜侵犯的独立危险因素。结论:经临床评估为局限性前列腺癌的患者行前列腺根治性切除术后病理检查可能发现包膜侵犯,前列腺体积小和穿刺Gleason评分高是其独立危险因素,在临床工作中应予以重视。
Objective: To investigate the risk factors of pathological capsule invasion in patients with clinically localized prostate cancer after radical resection. Methods: The clinical data of 191 patients diagnosed as localized prostate cancer diagnosed by prostate biopsy and clinical evaluation were retrospectively analyzed. Age, body mass index (BMI), prostate specific antigen (PSA), prostate volume (PV) The number of puncture needle, puncture positive percentage, clinical stage, puncture Gleason score, etc., according to radical prostatectomy pathological specimens to assess the envelope invasion, single factor and multivariate Logistic regression analysis of clinical limited prostatectomy after radical resection Pathological invasion of risk factors envelope. Results: There were 45 cases (23.6%) of pathological findings of envelope invasion in 191 patients with clinical limited prostate cancer. The results of univariate analysis showed that the smaller the prostate volume, the higher the Gleason score and the higher the positive percentage of puncture The postoperative pathological invasion of the envelope was significantly increased. Multivariate logistic regression analysis showed that the smaller prostate (P = 0.023) and the higher Gl-eason score (P = 0.019) were found to be pathologically found in patients with clinically localized prostate cancer An independent risk factor for envelope invasion. CONCLUSIONS: In patients undergoing radical prostatectomy clinically assessed for radical prostatectomy, invasion of the envelope, small prostate volume, and high Gleason score may be independent risk factors and should be addressed in clinical practice.