摘要
目的：通过将前列腺癌根治术后Gleason评分3＋4和4＋3患者进行对比，评价不同主要Gleason级别患者的临床特征差异。方法：回顾分析2001～2006年于我院行耻骨后前列腺根治性切除术的前列碌碌癌患者，37例木后病理诊断为Gleason7分，根据主要级别不同分为3＋4、4＋3两组。定期随访判断患者有无生化复发或远处转移。应用放射免疫法检测血清前列腺特异性抗辱（PSA）浓度，Kaplan—Meier法描述两组患者无进展生存曲线，COX回归模型分析影响疾病进展的独立相关田素。结果：两组患者前列腺包膜外侵犯率无统计学差异（21．1％ vs 33．3％，P=0．462）；3＋4组患者术后无进展生存时间长于4＋3组（P=0．030）；COX回归模型显示Gleason级别是影响预后的独立相关因素（P=0．033），4＋3组有着更高的生化复发风险。结论：不同分级的Gleason7分前列腺癌的生物学行为不尽相同，根治术后3＋4分和4＋3分患者的预后明显不同，将Gleason7分患者依照主要级别继续分型在临床上具有一定的可行性。
Objective：To compare the clinical characteristics of patients with Gleason score 3＋ 4 and Gleason score 4＋ 3 after radical prostatectomy for prostate cancer. Methods： The clinical records of patients who underwent radical retropubic prostatectomy in our hospital from 2001 to 2006 were retrospectively analyzed. Thirty-seven patients with a Gleason score of 7 after operation were divided into 2 groups.Gleason score 3＋4 group and （;leason score 4＋3 group,accordlng to major grading. The patients were followed up for biochemical recurrence and distant metastases. Radioimmunoassay was used to detect the serum prostate-specific antigen （PSA） level. Kaplan-Meier method was used to compare the progression-free survival curves and Cox regression model was used to analyze the independent factors influencing the disease progression. Results： The rates of extraprostatic extension at radical prostatectomy were not significantly different between 3＋4 and 4＋3 groups （21. 1% vs 33.3%,P=0. 462）. The non progression survival time of 3＋ 4 group was markedly longer than that of 4＋ 3 group （P= 0. 030）. Cox regression model showed that Gleason primary grade was an independent factor of prognosis （P= 0. 033）. 4＋ 3 group had a higher risk for biochemical recurrence. Conclusion： Prostate cancers of Gleason score 7 with different grades have different biologic behaviors. The prognoses of patients in 3＋4 group and 4 ＋ 3 group are different after operation. It is quite feasible to further classify the patients with Gleason 7 according to major grades.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2008年第8期904-907,共4页
Academic Journal of Second Military Medical University
