摘要
目的:探讨临床局限性前列腺癌根治性切除术后病理发现包膜侵犯的危险因素。方法:回顾性分析191例经前列腺穿刺活检确诊并临床评估为局限性前列腺癌患者对临床资料,收集患者确诊时年龄、体重指数(BMI)、前列腺特异抗原(PSA)、前列腺体积(PV)、穿刺针数、穿刺阳性百分数、临床分期、穿刺Gleason评分等,根据前列腺根治性切除术后病理标本评估包膜侵犯情况,使用单因素和多因素Logistic回归分析临床局限性前列腺癌根治性切除术后病理包膜侵犯的危险因素。结果:191例临床局限性前列腺癌患者行根治性切除术后病理发现包膜侵犯者45例(23.6%),单因素分析显示前列腺体积较小组、穿刺Gleason评分较高组和穿刺阳性百分数较大组术后病理包膜侵犯比例明显增高,多因素Logistic回归分析显示前列腺体积小(P=0.023)和穿刺Gl-eason评分高(P=0.019)是临床局限性前列腺癌根治性切除术后发现病理包膜侵犯的独立危险因素。结论:经临床评估为局限性前列腺癌的患者行前列腺根治性切除术后病理检查可能发现包膜侵犯,前列腺体积小和穿刺Gleason评分高是其独立危险因素,在临床工作中应予以重视。
Objective：To explore the risk factors for postoperative pathologic extra-capsular extension in clini- cally diagnosed localized prostate cancer after radical prostatectomy. Method：We retrospectively evaluated 191 pa- tients who were biopsy proved prostatic carcinoma and clinically diagnosed localized prostate cancer. All patients included in the study had complete information for clinical variables, including age, body mass index（BMI）, pre- operative PSA level, prostate volume（PV）, number of biopsy cores obtained, percentage of clinical stage, biopsy Gleason score. We evaluated extra-capsular extension by operative pathologic test. Univariable and multivariable logistic regression analysis was used to identify predictors of pathological extra-capsular extension. Result： Of the 191 patients, 45（23.6~） patients found extra-capsular extension in operative pathologic test. Univariate and mul- tivariate regression analysis shows that prostate volume and biopsy Gleason score were independent predictors with postoperative extra--capsular extension. Conclusion： High biopsy Gleason score and smaller prostate volume were at increased risk for extra-capsular extension in clinically diagnosed localized prostate cancer after radical prostatec- tomy.
出处
《临床泌尿外科杂志》
2012年第12期901-903,906,共4页
Journal of Clinical Urology
关键词
前列腺肿瘤
包膜侵犯
前列腺根治性切除术
prostatic neoplasm
extra-capsular extension
radical prostatectomy
