| 摘要: |
| ［摘要］ 目的 探讨影响高危前列腺癌患者淋巴结转移(lymph node metastasis，LNM)的危险因素。方法 选取2016年1月至2020年12月新疆医科大学第一附属医院收治的105例高危前列腺癌患者的临床资料，均经腹膜外途径腹腔镜下前列腺癌根治术（eLRP）+扩大盆腔淋巴结清扫（ePLND）治疗。根据淋巴结病理结果分为病例组（LNM阳性，14例）和对照组（LNM阴性，91例）。比较两组术前年龄、体质量指数（BMI）、前列腺特异性抗原（PSA）、格里森评分（GS）、穿刺阳性针数百分比（PPBC）、前列腺体积（PV）和前列腺癌临床分期。采用二元logistic回归和列线图分析影响患者LNM的因素。结果 病例组GS>8分、前列腺癌临床分期>T2c期的人数比例大于对照组，PPBC高于对照组，差异有统计学意义（P<0.05）。二元logistic回归分析结果显示，前列腺癌临床分期>T2c期（OR=7.128，95%CI：1.316～38.618）、PSA 10～20 ng/ml（OR=10.679，95%CI：1.014～112.512）、GS>8分（OR=16.387，95%CI：2.147～125.092）和更大的PV（OR=2.938，95%CI：1.266～6.822）是促进患者发生LNM的危险因素（P<0.05）。列线图分析显示，前列腺癌临床分期和GS有较高的预测价值。结论 PSA、GS、前列腺癌临床分期及PV均与高危前列腺癌LNM的发生有关，且以前列腺癌临床分期和GS预测价值最高。 |
| 关键词: 高危前列腺癌 淋巴结转移 危险因素 |
| DOI：10.3969/j.issn.1674-3806.2021.10.15 |
| 分类号:R 737.25 |
| 基金项目:新疆维吾尔自治区自然科学基金青年项目（编号：2019D01C314） |
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| Analysis of risk factors of lymph node metastasis in patients with high-risk prostate cancer |
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SONG Hong-wen, YAN Shen-shen, ASIMUJIANG Abula, et al.
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Department of Urology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
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| Abstract: |
| ［Abstract］ Objective To explore the risk factors affecting lymph node metastasis(LNM) in patients with high-risk prostate cancer. Methods The clinical data of 105 high-risk prostate cancer patients who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2020 were selected, all of whom received extra-peritoneal laparoscopic radical prostatectomy(eLRP)+extended pelvic lymph node dissection(ePLND) treatment. The patients were divided into case group(LNM positive, 14 cases) and control group(LNM negative, 91 cases) according to their lymph node pathology results. The preoperative age, Body Mass Index(BMI), prostate specific antigen(PSA), Gleason score(GS), percentage of positive biopsy cores(PPBC), prostate volume(PV), and prostate clinical stage were compared between the two groups. Binary logistic regression and nomogram were used to analyze the factors affecting LNM of the patients. Results The proportion of the patients in the case group with GS>8 points and the clinical stage of prostate cancer >T2c stage was greater than that in the control group, and PPBC in the case group was higher than that in the control group, and the differences were statistically significant(P<0.05). The results of binary logistic regression analysis showed that the clinical stage of prostate cancer >T2c stage(OR=7.128, 95%CI: 1.316-38.618), PSA 10-20 ng/ml(OR=10.679, 95%CI: 1.014-112.512), GS>8 points(OR=16.387, 95%CI: 2.147-125.092) and greater PV(OR=2.938, 95%CI: 1.266-6.822) were the risk factors for promoting LNM(P<0.05). The nomogram analysis showed that the clinical stage of prostate cancer and GS had higher predictive value. Conclusion PSA, GS, clinical stage of prostate cancer and PV are all related to the occurrence of LNM for high-risk prostate cancer, and the clinical stage of prostate cancer and GS have the highest predictive value. |
| Key words: High-risk prostate cancer Lymph node metastasis(LNM) Risk factors |
