摘要
目的:分析接受根治性前列腺切除术(radical prostatectomy,RP)的年轻前列腺癌患者(年龄<50岁)的临床、病理特征及预后,为临床诊疗提供指导,并为未来前列腺癌发病及进展的分子生物学机制研究奠定基础。方法:回顾性分析2009年10月—2024年4月复旦大学附属肿瘤医院收治的76例接受RP的年轻前列腺癌患者的临床资料。收集并分析患者的年龄、家族史、术前PSA水平、MRI、骨扫描或PET-CT、前列腺穿刺活检病理结果、手术方式、术后病理及随访信息等数据。其中RP后生化复发(biochemical recurrence,BCR)定义为术后连续2次PSA水平>0.2 ng/mL。采用Kaplan-Meier法分析无生化复发生存(biochemical recurrence-free survival,bRFS)曲线。结果:76例患者的中位年龄为47岁,8例(10.53%)患者有前列腺癌家族史。入组患者确诊时PSA中位值为15.9 ng/mL,8例(10.53%)患者为cM1期(含1例cM1a期、5例cM1b期、2例cM1c期)。RP术后病理提示,35例(46.05%)患者为pT3~T4期,7例(9.21%)患者证实有区域淋巴结转移。术后随访发现,入组的58例局限性及局部进展期的患者中,有15例(25.86%)患者出现了BCR,其2年、5年和10年bRFS率分别为81.96%、65.62%和57.60%。此外,年轻患者中具有前列腺癌家族史的比例较高,提示遗传因素可能在年轻前列腺癌的发生中起重要作用。结论:年轻前列腺癌患者具有较晚的临床分期和较高的家族史比例,且术后BCR风险较高,需密切随访管理。这项研究为年轻前列腺癌患者的临床诊疗提供了经验,并为进一步的生物学机制研究提供了依据。
Objective To analyze the clinical and pathological characteristics,as well as prognosis,of young prostate cancer patients(aged<50 years)who received radical prostatectomy,providing guidance for clinical diagnosis and treatment and laying a foundation for future molecular biological research on the pathogenesis and progression of prostate cancer.Methods A retrospective analysis was conducted on 76 young prostate cancer patients who underwent radical prostatectomy at Fudan University Shanghai Cancer Center between October 2009 and April 2024.Data collected and analyzed included patients'age,family history,preoperative PSA levels,MRI,bone scans or PET-CT,prostate biopsy pathology results,surgical approach,postoperative pathology,and follow-up information.Biochemical recurrence(BCR)after radical prostatectomy was defined as a consecutive PSA level>0.2 ng/mL.Kaplan-Meier survival analysis was used to evaluate biochemical recurrence-free survival(bRFS)curves.Results The median age of the 76 patients was 47 years,with 8 patients(10.53%)having a family history of prostate cancer.The median preoperative PSA was 15.9 ng/mL,and 8 patients(10.53%)were diagnosed with cM1 stage(including 1 cM1a,5 cM1b,and 2 cM1c).Postoperative pathology revealed that 35 patients(46.05%)were in pT3-T4 stages,and 7 patients(9.21%)had confirmed regional lymph node metastasis.During the follow-up of 58 patients with localized and locally advanced prostate cancer,15 patients(25.86%)experienced BCR.The 2-year,5-year,and 10-year bRFS rates were 81.96%,65.62%,and 57.60%,respectively.Furthermore,a higher proportion of patients had a family history of prostate cancer,suggesting that genetic factors may play an important role in the development of young prostate cancer.Conclusion Young prostate cancer patients have more advanced clinical staging,and a higher proportion of family history,as well as an increased risk of postoperative BCR,requiring close follow-up and management.This study provides valuable clinical experience for the management of young prostate cancer patients and serves as a basis for further research on the biological mechanisms of this disease.
作者
许华
沈祐民
戴波
XU Hua;SHEN Youmin;DAI Bo(Department of Urology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College of Fudan University,Shanghai,200032,China)
出处
《临床泌尿外科杂志》
2025年第6期509-513,共5页
Journal of Clinical Urology
关键词
前列腺癌
年轻
生化复发
prostate cancer
young age
biochemical recurrence
