摘要
目的探讨高脂血症与前列腺癌发生及临床进展的相关性。方法对福建医科大学附属漳州市医院收治的112例疑似前列腺癌经前列腺穿刺活检病理证实并行前列腺癌根治术的患者进行回顾性分析。结果 112例患者中合并高脂血症64例(57.14%)。与单纯前列腺癌相比,前列腺癌合并高脂血症的患者发病年龄明显较小(65.0±5.0岁vs.67.8±3.7岁,P=0.001),前列腺体积更大(75.0±11.7 mL vs.54.5±8.5 mL,P<0.001),血清总前列腺特异性抗原(TPSA)水平明显升高(61.4±23.3 ng/mL vs.33.4±14.9 ng/mL,P<0.001),TNM临床分期明显更晚(P<0.001),Gleason评分明显升高(6.9±1.8 vs.5.0±1.9,P<0.001),生存时间更短(49.8±12.7月vs.57.3±6.2月,P<0.001),五年生存率(5-YSR)明显降低(51.6%vs.77.1%,P=0.006)。胆固醇的升高、甘油三脂的升高和高密度脂蛋白的降低与发病年龄年轻化、前列腺体积增大、TPSA水平升高、TNM临床分期及Gleason评分升高、生存时间缩短及5-YSR下降密切相关(P<0.05)。多因素分析结果显示高脂血症(OR=3.204,P=0.022)和Gleason评分(OR=8.611,P<0.001)是患者预后的独立危险因素。结论前列腺癌合并高脂血症临床多见,高脂血症有可能是前列腺癌发生与临床进展的危险因素之一。
ObjectiveTo assess whether hyperlipoidemia affects the occurrence and progression of prostate cancer （PCA）. MethodsA hospital based retrospective study was carried out in Zhangzhou Affiliated Hospital of Fujian Medical University using data from a total of 112 cases of PCA, which underwent radical prostatectomy due to suspected PCA and confirmed by prostate biopsy pathology. ResultsOf the 112 PCA patients, 64 （57.14%） were PCA with hyperlipoidemia （PCA-H）. Compared with PCA patients, the patients of PCA-H patients had younger onset age （65.0±5.0 vs. 67.8±3.7, P=0.001）, increased prostate volume （75.0±11.7 mL vs. 54.5±8.5 mL, P〈0.001）, increased level of TPSA （61.4±23.3 ng/mL vs. 33.4±14.9 ng/mL, P〈0.001）, and Gleason grade （6.9±1.8 vs. 5.0±1.9, P〈0.001）, later clinical stage （P〈0.001）, shorter survival time （49.8±12.7 months vs. 57.3±6.2 months, P〈0.001） and decreased 5 years of survival rate （51.6% vs. 77.1%, P=0.006）. The level of cholesterol, triglyceride and high density lipoprotein was significantly associated with the rejuvenation of onset age, the enlargement of prostate volume, increasing of serum TPSA, the progression of TNM clinical stage, increasing of Gleason grade, shorten of survival time and dropping of 5 years of survival rate （P〈0.05）. In multiple-factor regression analysis, only hyperlipoidemia （OR=3.204, P=0.022） and Gleason grade （OR=8.611, P〈0.001） were the independent risk factors of prognosis. ConclusionThe situation of PCA with hyperlipoidemia is frequently noted in clinics, and hyperlipoidemia may be one of the risk factors in the processes of PCA growth and progression.
出处
《中国循证医学杂志》
CSCD
2014年第4期414-417,共4页
Chinese Journal of Evidence-based Medicine
关键词
前列腺癌
高脂血症
危险因素
Prostate cancer
Hyperlipoidemia
Risk factor
