摘要
目的探讨电切术、手术去势联合间断性内分泌治疗对前列腺癌患者临床症状及血清肿瘤相关因子水平的影响。方法选取2014年3月至2015年11月收治的116例晚期前列腺癌患者,采用随机数字表法分为治疗组和对照组,每组58例。对照组采用间断性内分泌治疗,治疗组在对照组的基础上联合电切术、手术去势治疗。2组均连续治疗1年。通过前列腺症状、生活质量改善情况评价2组临床治疗效果,比较2组治疗效果,检测并比较2组治疗前后血清肿瘤相关因子水平变化。结果与治疗前比较,治疗后2组国际前列腺症状评分表(IPSS)、梗阻症状、刺激症状评分均显著降低(P <0. 01),且治疗组低于对照组(P <0. 05);与治疗前比较,治疗后2组生活质量评定量表(QOL)各领域评分均显著升高(P <0. 05或<0. 01),且治疗组高于对照组(P <0. 05或<0. 01);与治疗前比较,治疗后2组血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)水平显著降低,微小miR-34a水平显著升高(P <0. 01),且2组间差异有统计学意义(P <0. 05或<0. 01)。结论电切术、手术去势联合间断性内分泌治疗能够降低前列腺癌患者VEGF、IGF-1水平,提高miR-34a水平,从而抑制肿瘤生长,改善患者前列腺症状和生活质量,值得推广。
Objective To investigate the effects of electrocision,surgical castration and intermittent endocrine therapy on clinical symptoms and serum tumor-related factors in patients with prostate cancer. Methods A total of 116 patients with advanced prostate cancer who were admitted and treated from March 2014 to November 2015 were randomly divided into the treatment group( n = 58) and the control group( n = 58),according to random number table method. Patients in the control group were treated with intermittent endocrine therapy,and those in the treatment group were supplemented with electrocision and surgical castration on the basis of the control group. The patients in both groups were treated continuously for1 year. The clinical effects of the two groups were evaluated by the symptoms of prostate and the improvement of quality of life. The therapeutic effects of the two groups were compared,and changes of the levels of serum tumor-related factors were measured and compared before and after treatment. Results As compared with those before treatment,international prostate symptom scores( IPSS),obstructive symptoms,and irritation symptom scores in both groups were significantly lower after treatment( P < 0. 01),and these indicators in the treatment group was lower than those in the control group( P < 0. 05).Compared with those before treatment,the scores of quality of life( QOL) in the two groups were significantly increased after treatment( P < 0. 05 or P < 0. 01),which were higher in the treatment group than that in the control group( P < 0. 05 or P <0. 01). As compared with those before treatment,the levels of vascular endothelial growth factor( VEGF) and insulin-like growth factor-1( IGF-1) were significantly decreased in the two groups after treatment,whereas the level of micro-miR-34 a was significantly increased( P < 0. 01),and the difference between the two groups was statistically significant( P < 0. 05 or P < 0. 01). Conclusion Electrocision and surgical castration combined with intermittent endocrine therapy can reduce the levels of VEGF and IGF-1 in prostate cancer patients,and increase the level of miR-34 a,thereby inhibiting tumor growth,alleviating prostate symptoms and improving quality of life. Therefore,it is worth of popularization in clinical practice.
作者
张小平
ZHANG Xiaoping(Department of Urinary Surgery,Chongqing Red Cross Hospital（Jiangbei District People＇s Hospital）,Chongqing 400000,China)
出处
《河北医药》
CAS
2018年第24期3760-3762,3766,共4页
Hebei Medical Journal
关键词
前列腺癌
电切术
手术去势
间断性内分泌治疗
肿瘤相关因子
prostate cancer
electrocision
surgical castration
internfittent endocrine therapy
tumor-related factors
