根治性前列腺癌切除术后患者生化复发危险因素分析.docVIP

根治性前列腺癌切除术后患者生化复发危险因素分析 　　[摘要] 目的 分析根治性前列腺癌切除术（RP）后患者生化复发（BCR）的危险因素。 方法 回顾性分析2006年1月～2014年12月进行RP治疗的486例前列腺癌患者的临床和随访资料，记录患者术前、术中、术后和随访的相关参数。根据是否术后出现BCR，将患者分为复发组和非复发组。比较两组患者相关参数差异，运用Cox回归模型进行多因素分析。 结果 复发组患者术前PSA值（39.2±27.8）μg/L、术前Gleason评分（7.26±1.13）、术后Gleason评分（7.14±1.10）、手术切缘阳性率（20.5%）、包膜侵犯阳性率（21.1%）、精囊侵犯阳性率（19.5%）、淋巴结转移阳性率（20.5%）显著高于非复发组[（31.4±27.2）、（6.81±1.31）、（6.89±1.26）、（8.3%）、（9.0%）、（8.3%）和（7.6%），P0.05]。两组患者在临床分期、病理分期方面有显著差异（P0.05）。Cox回归分析结果显示：术前PSA值、术前Gleason评分、病理分期、精囊侵犯和淋巴结转移是RP后BCR的主要危险因素（P0.05）。 结论 术前PSA、术前Gleason评分、病理分期、精囊侵犯和淋巴结转移是RP后BCR的主要危险因素。 　　[关键词] 前列腺肿瘤；根治性前列腺癌切除术；生化复发；危险因素 　　[中图分类号] R737.25 [文献标识码] B [文章编号] 1673-9701（2016）10-0044-03 　　[Abstract] Objective To analyze the risk factors for biochemical recurrence（BCR） after radical prostatectomy （RP）. Methods Clinical and follow-up data of 486 patients with prostate cancer who received RP from January 2006 to December 2014 were retrospectively analyzed. Relevant parameters of patients before the surgery， during the surgery， after the surgery and during follow-up were recorded. The patients were assigned to the recurrence group and non-recurrence group according to wether BCR occurred after the surgery. The differences of relevant parameters were compared between the two groups of patients， and multi-variate analysis was performed by Cox regression model. Results In the patients in recurrence group， PSA value before the surgery was（39.2±27.8）， Gleason score before the surgery was （7.26±1.13）， Gleason score after the surgery was （7.14±1.10）， positive rate of surgical cutting margin was 20.5%， positive rate of capsular invasion was 21.1%， positive rate of seminal vesicle invasion was 19.5%， and positive rate of lymph node metastasis was 20.5%， all higher than those of （31.4±27.2）， （6.81±1.31）， （6.89±1.26）， （8.3%）， （9.0%）， （8.3%） and （7.6%） in the non-recurrence group（P0.05）. There were significant differences between the two groups in terms of clinical staging and pathological staging （P0.05）. The re