中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2014年
5期
341-345
,共5页
熊太林%贺大林%樊桂玲%李磊%南勋义%范晋海
熊太林%賀大林%樊桂玲%李磊%南勛義%範晉海
웅태림%하대림%번계령%리뢰%남훈의%범진해
前列腺癌%去势抵抗性前列腺癌%前列腺特异性抗原%内分泌治疗%Gleason评分
前列腺癌%去勢牴抗性前列腺癌%前列腺特異性抗原%內分泌治療%Gleason評分
전렬선암%거세저항성전렬선암%전렬선특이성항원%내분비치료%Gleason평분
Prostate cancer%Castrate-resistant prostate cancer%Prostate-specific antigen%Hormonal therapy%Gleason score
目的 探讨前列腺癌患者内分泌治疗后1年内进展为去势抵抗性前列腺癌(castrateresistant prostate cancer,CRPC)的相关因素. 方法 选取2008年1月至2011年1月收治的前列腺癌患者131例.年龄44～ 89岁,平均70岁,其中＜60岁13例(9.9％)、60～ 69岁43例(32.8％)、70～79岁62例(47.3％)、≥80岁13例(9.9％).体质指数(BMI) 14.4～ 34.4 kg/m2,平均23.0 kg/m2,其中＜18.5 kg/m2 10例、18.5～24.0 kg/m2 77例、24.1～28.0 kg/m2 34例、＞28.0 kg/m210例.初始PSA值0.3～4 707.0 μg/L,其中＜20 μg/L 19例(14.5％)、20 ～ 99μg/L 45例(34.4％)、≥100 μg/L 67例(51.1％).临床分期:T1期1例(0.7％)、T2期39例(29.8％)、T3期59例(45.0％)、T4期32例(24.4％).Gleason评分:4分5例(3.8％)、5分13例(9.9％)、6分24例(18.3％)、7分51例(38.9％)、8分26例(19.8％)、9分9例(6.9％)、10分3例(2.3％).96例(73.3％)确诊时伴有骨转移,其中2例伴有肺转移,1例伴有肝转移.均予手术或药物去势加抗雄激素药物治疗.对内分泌治疗后进展为CRPC者,记录内分泌治疗的时间.采用单因素分析及多因素Logistic回归分析CRPC与患者年龄、BMI、初始PSA值、临床TNM分期及Gleason评分等的相关性. 结果 本组131例中,内分泌治疗1年后32例(24.4％)进展为CRPC.其中＜60岁3例,60～ 69岁15例,70 ～ 79岁12例,≥80岁2例,分别占各组的23.1％、34.9％、19.4％、15.4％;BMI:＜18.5 kg/m2 3例、18.5 ～ 24.0 kg/m219例、25.0～28.0 kg/m2 7例、＞28.0 kg/m2 3例,分别占各组的30.0％、24.7％、20.6％、30.0％;初始PSA值:＜20 μg/L 4例、20～99 μg/L 6例、≥100 μg/L 22例,分别占各组的21.1％、13.3％、32.8％.临床分期:T2期4例、T3期13例、T4期15例,分别占各组的10.0％、22.0％、46.9％,无T1期患者.Gleason评分:6分2例、7分11例、8分11例、9分6例、10分2例,分别占各组的8.3％、21.6％、42.3％、66.7％、66.7％,无4、5分患者.伴有骨转移29例,无骨转移3例,分别占各组的30.2％、8.6％.单因素分析结果显示1年内进展为CRPC的患者与未进展者的临床TNM分期(P=0.001)、Gleason评分(P＜0.001)及转移情况(P=0.011)比较差异具有统计学意义.多因素Logistic回归分析结果显示临床TNM分期(P=0.017)及Gleason评分(P＜0.001)是1年内进展为CRPC的独立危险因素. 结论 临床TNM分期及Gleason评分是前列腺癌患者内分泌治疗后1年内进展为CRPC的独立危险因素.临床TNM分期越晚、Gleason评分越高,1年内进展为CRPC的风险越大.
目的 探討前列腺癌患者內分泌治療後1年內進展為去勢牴抗性前列腺癌(castrateresistant prostate cancer,CRPC)的相關因素. 方法 選取2008年1月至2011年1月收治的前列腺癌患者131例.年齡44～ 89歲,平均70歲,其中＜60歲13例(9.9％)、60～ 69歲43例(32.8％)、70～79歲62例(47.3％)、≥80歲13例(9.9％).體質指數(BMI) 14.4～ 34.4 kg/m2,平均23.0 kg/m2,其中＜18.5 kg/m2 10例、18.5～24.0 kg/m2 77例、24.1～28.0 kg/m2 34例、＞28.0 kg/m210例.初始PSA值0.3～4 707.0 μg/L,其中＜20 μg/L 19例(14.5％)、20 ～ 99μg/L 45例(34.4％)、≥100 μg/L 67例(51.1％).臨床分期:T1期1例(0.7％)、T2期39例(29.8％)、T3期59例(45.0％)、T4期32例(24.4％).Gleason評分:4分5例(3.8％)、5分13例(9.9％)、6分24例(18.3％)、7分51例(38.9％)、8分26例(19.8％)、9分9例(6.9％)、10分3例(2.3％).96例(73.3％)確診時伴有骨轉移,其中2例伴有肺轉移,1例伴有肝轉移.均予手術或藥物去勢加抗雄激素藥物治療.對內分泌治療後進展為CRPC者,記錄內分泌治療的時間.採用單因素分析及多因素Logistic迴歸分析CRPC與患者年齡、BMI、初始PSA值、臨床TNM分期及Gleason評分等的相關性. 結果 本組131例中,內分泌治療1年後32例(24.4％)進展為CRPC.其中＜60歲3例,60～ 69歲15例,70 ～ 79歲12例,≥80歲2例,分彆佔各組的23.1％、34.9％、19.4％、15.4％;BMI:＜18.5 kg/m2 3例、18.5 ～ 24.0 kg/m219例、25.0～28.0 kg/m2 7例、＞28.0 kg/m2 3例,分彆佔各組的30.0％、24.7％、20.6％、30.0％;初始PSA值:＜20 μg/L 4例、20～99 μg/L 6例、≥100 μg/L 22例,分彆佔各組的21.1％、13.3％、32.8％.臨床分期:T2期4例、T3期13例、T4期15例,分彆佔各組的10.0％、22.0％、46.9％,無T1期患者.Gleason評分:6分2例、7分11例、8分11例、9分6例、10分2例,分彆佔各組的8.3％、21.6％、42.3％、66.7％、66.7％,無4、5分患者.伴有骨轉移29例,無骨轉移3例,分彆佔各組的30.2％、8.6％.單因素分析結果顯示1年內進展為CRPC的患者與未進展者的臨床TNM分期(P=0.001)、Gleason評分(P＜0.001)及轉移情況(P=0.011)比較差異具有統計學意義.多因素Logistic迴歸分析結果顯示臨床TNM分期(P=0.017)及Gleason評分(P＜0.001)是1年內進展為CRPC的獨立危險因素. 結論 臨床TNM分期及Gleason評分是前列腺癌患者內分泌治療後1年內進展為CRPC的獨立危險因素.臨床TNM分期越晚、Gleason評分越高,1年內進展為CRPC的風險越大.
목적 탐토전렬선암환자내분비치료후1년내진전위거세저항성전렬선암(castrateresistant prostate cancer,CRPC)적상관인소. 방법 선취2008년1월지2011년1월수치적전렬선암환자131례.년령44～ 89세,평균70세,기중＜60세13례(9.9％)、60～ 69세43례(32.8％)、70～79세62례(47.3％)、≥80세13례(9.9％).체질지수(BMI) 14.4～ 34.4 kg/m2,평균23.0 kg/m2,기중＜18.5 kg/m2 10례、18.5～24.0 kg/m2 77례、24.1～28.0 kg/m2 34례、＞28.0 kg/m210례.초시PSA치0.3～4 707.0 μg/L,기중＜20 μg/L 19례(14.5％)、20 ～ 99μg/L 45례(34.4％)、≥100 μg/L 67례(51.1％).림상분기:T1기1례(0.7％)、T2기39례(29.8％)、T3기59례(45.0％)、T4기32례(24.4％).Gleason평분:4분5례(3.8％)、5분13례(9.9％)、6분24례(18.3％)、7분51례(38.9％)、8분26례(19.8％)、9분9례(6.9％)、10분3례(2.3％).96례(73.3％)학진시반유골전이,기중2례반유폐전이,1례반유간전이.균여수술혹약물거세가항웅격소약물치료.대내분비치료후진전위CRPC자,기록내분비치료적시간.채용단인소분석급다인소Logistic회귀분석CRPC여환자년령、BMI、초시PSA치、림상TNM분기급Gleason평분등적상관성. 결과 본조131례중,내분비치료1년후32례(24.4％)진전위CRPC.기중＜60세3례,60～ 69세15례,70 ～ 79세12례,≥80세2례,분별점각조적23.1％、34.9％、19.4％、15.4％;BMI:＜18.5 kg/m2 3례、18.5 ～ 24.0 kg/m219례、25.0～28.0 kg/m2 7례、＞28.0 kg/m2 3례,분별점각조적30.0％、24.7％、20.6％、30.0％;초시PSA치:＜20 μg/L 4례、20～99 μg/L 6례、≥100 μg/L 22례,분별점각조적21.1％、13.3％、32.8％.림상분기:T2기4례、T3기13례、T4기15례,분별점각조적10.0％、22.0％、46.9％,무T1기환자.Gleason평분:6분2례、7분11례、8분11례、9분6례、10분2례,분별점각조적8.3％、21.6％、42.3％、66.7％、66.7％,무4、5분환자.반유골전이29례,무골전이3례,분별점각조적30.2％、8.6％.단인소분석결과현시1년내진전위CRPC적환자여미진전자적림상TNM분기(P=0.001)、Gleason평분(P＜0.001)급전이정황(P=0.011)비교차이구유통계학의의.다인소Logistic회귀분석결과현시림상TNM분기(P=0.017)급Gleason평분(P＜0.001)시1년내진전위CRPC적독립위험인소. 결론 림상TNM분기급Gleason평분시전렬선암환자내분비치료후1년내진전위CRPC적독립위험인소.림상TNM분기월만、Gleason평분월고,1년내진전위CRPC적풍험월대.
Objective To investigate the risk factors for castrate-resistant prostate cancer (CRPC) after prostate cancer treated with androgen deprivation therapy (ADT) within 1 year.Methods One hundred and thirty-one prostate cancer patients treated with ADT in our institute between Jan.2008 and Jan.2011 were selected for this study.Patients were followed up by telephone or in clinic,including serum testosterone,serum PSA,clinical symptoms,imaging studies,digital rectal examination (DRE),survival data,PSA nadir,time to PSA nadir and et al.We mainly studied the CRPC after prostate cancer treated with ADT within 1 year.In the 131 patients,the median age was 70 (ranged from 44-89) years.There were 13 patients (9.9％) less than 60 years,43 patients (32.8％) between 60 and 69 years,62 patients (47.3％) between 70 and 79 years,13 patients (9.9％) more than 80 years.The average body mass index (BMI) was 23.0 (ranged from 14.4-34.4) kg/m2.There were 10 patients less than 18.5 kg/m2,77 patients between 18.5 and 24.0 kg/m2,34 patients between 24.1 and 28.0 kg/m2,and 10 patients more than 28.0 kg/m2.The initial PSA was between 0.3 and 4 707.0 μg/L,there were 19 patients (14.5％) less than 20 μg/L,45 patients (34.4％) between 20 and 99 μg/L,67 patients (51.1％) more than 100 μg/L.One patient (0.7％) was in T1,39 patients (29.8％) in T2,59 patients (45.0％) in T3,32 patients (24.4％) in T4.5 patients (3.8％) were with Gleason score 4,13 patients (9.9％) were with Gleason score 5,24 patients (18.3％) were with Gleason score 6,51 patients (38.9％) were with Gleason score 7,26 patients (19.8％) were with Gleason score 8,9 patients (6.9％) were with Gleason score 9,3 patients (2.3％) were with Gleason score 10.Results There were 32 of 131 patients (24.4％) progressed to CRPC after treated with ADT within 1 year.In the CRPC group,there were 3 patients less than 60 years,15 patients between 60 and 69 years,12 patients between 70 and 79 years,2 patients more than 79 years; 3 patients were less than 18.5 kg/m2,19 patients were between 18.5 and 24.0 kg/m2,7 patients were between 24.0 and 28.0 kg/m2,3 patients were more than 28.0 kg/m2 ; 4 patients were less than 20 μg/L,6 patients were between 20 and 100 μg/L,22 patients were more than 100 μg/L; 4 patients were in T2,13 patients were in T3,15 patients were in T4; 2 patients were with Gleason score 6,11 patients were with Gleason score 7,11 patients were with Gleason score 8,6 patients were with Gleason score 9,2 patients were with Gleason score 10; 29 patients were with metastasis,3 patients without metastasis.Clinical stage (P =0.001),Gleason score (P＜0.001) and metastasis (P=0.011) were statistically significant between the CRPC within 1 year group and the rest group.Conclusions The clinical stage and Gleason score are the risk factors of CRPC treated with ADT within 1 year.The higher of the clinical stage and Gleason score,the greater risk to be the CRPC within 1 year.
