摘要
目的探讨动态血清前列腺特异性抗原(PSA)水平与经尿道前列腺切除术(TURP)后偶发前列腺癌患者根治术后预后间的相关性。方法选取2017年1月至2018年4月北京市和平里医院收治的151例TURP后确诊为局限性前列腺癌并接受前列腺根治术的患者作为研究对象。随访观察3年,以出现无进展生存期作为研究终点,并以此分为进展组和非进展组。比较两组的基线资料、PSA动态水平,采用多因素Cox回归筛选预后影响因素。结果最终纳入142例,其中54例出现疾病进展(38.03%),88例未出现疾病进展(61.97%);Kaplan-Meier分析法显示,第1、2、3年无进展生存率分别为95.07%、77.46%、61.97%。两组Gleason评分、初始PSA水平、PSA谷值(nPSA)、PSA速率(PSAV)、PSA达谷时间(TTPN)比较,差异具有统计学意义(P<0.05);多因素Cox回归分析结果显示:Gleason评分(HR=1.181,95%CI:1.013~1.376)、初始PSA水平(HR=1.075,95%CI:1.042~1.111)、nPSA(HR=1.880,95%CI:1.106~3.196)、PSAV(HR=3.028,95%CI:1.567~5.850)是前列腺癌患者预后的危险因素(P<0.05),TTPN(HR=0.826,95%CI:0.699~0.975)是保护因素(P<0.05)。结论PSA动态水平可作为TURP后偶发前列腺癌患者根治术后预后的预测因子,可指导临床医生决策。
Objective To investigate the correlation between dynamic serum prostate-specific antigen(PSA)level and prognosis of patients with incidental radical prostatectomy after transurethral resection of the prostate(TURP).Methods From January 2017 to April 2018,151 patients who were diagnosed with localized prostate cancer and underwent radical prostatectomy after being treated with TURP in Beijing Hepingli Hospital were selected as study objects.Patients were followed up and observed for 3 years and progression-free survival was used as study endpoint,according to which patients were divided into progressive group and non-progressive groups.The baseline data and dynamic levels of PSA were compared between the two groups,and multivariate Cox regression was used to screen prognostic factors.Results Finally,a total of 142 cases were included,of which 54 cases had disease progression(38.03%)and 88 cases had no disease progression(61.97%).The Kaplan-Meier method showed that the first-year,second-year,and third-year progression-free survival rates were 95.07%,77.46%,and 61.97%,respectively.The difference in Gleason score,initial PSA level,PSA trough value(nPSA),PSA rate(PSAV),and PSA trough time(TTPN)between the two groups was statistically significant(P0.05).Multivariate Cox regression analysis showed:Gleason score(HR=1.181,95%CI:1.013-1.376),initial PSA level(HR=1.075,95%CI:1.042-1.111),nPSA(HR=1.880,95%CI:1.106-3.196),PSAV(HR=3.028,95%CI:1.567-5.850)are risk factors for the prognosis of prostate cancer patients,and TTPN(HR=0.826,95%CI:0.699-0.975)are protective factors(all P0.05).Conclusions Dynamic PSA level can be used as a prognostic predictor for patients with incidental radical prostatectomy after TURP,and guide clinicians to make decisions.
作者
钟晔
刘建
ZHONG Ye;LIU Jian(Department of Urology,Beijing Hepingli Hospital,Beijing100013,China)
出处
《中国性科学》
2023年第9期49-52,共4页
Chinese Journal of Human Sexuality
关键词
前列腺癌
经尿道前列腺切除术
血清前列腺特异性抗原
预后
Prostate cancer
Transurethral resection of the prostate
Serum prostate-specific antigen
Prognosis
