| 姚健翔,方志海,沈俊文,王荣江.单针阳性前列腺癌术后Gleason评分升级影响因素分析[J].浙江中西医结合杂志,2024,34(11): |
| 单针阳性前列腺癌术后Gleason评分升级影响因素分析 |
| Influencing factors for Gleason score upgrading of single-positive-core prostate cancer |
| 投稿时间：2023-12-18 修订日期：2024-05-26 |
| DOI： |
| 中文关键词: 前列腺癌 单针阳性 Gleason评分升级 影响因素 |
| 英文关键词:Prostate cancer single positive core Gleason score upgrading |
| 基金项目:浙江省医学会临床医学专项资金项目(2023ZYC-Z16) |
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| 中文摘要: |
| 【摘要】目的 分析影响穿刺单针阳性的前列腺癌患者前列腺根治性切除术后病理Gleason评分升级的因素。 方法 对84例来自湖州市第一人民医院2020年1月至2023年2月经会阴超声引导下前列腺穿刺结果为单针阳性的前列腺癌患者数据进行回顾性分析,数据包括患者的年龄、穿刺前血清TPSA值、前列腺MRI报告、穿刺及术后的 Gleason评分、术后病理脉管侵犯情况、包膜侵犯情况、切缘阳性情况等,根据Gleason评分差异将患者分为Gleason评分升级组与未升级组,比较两组间各影响因素的差异,对各因素进行单因素和多因素Logistic分析。 结果 穿刺单针阳性的84例患者中有35例出现术后Gleason评分升级。Gleason评分＜7分的有13例,Gleason评分≥7分的有22例。不同TPSA值、MRI结果、穿刺Gleason评分组术后Gleason升级率的差异有统计学意义。Gleason评分升级组与未升级组的术后脉管包膜侵犯发生率的差异有统计学意义。多因素分析显示TPSA值、穿刺Gleason评分及MRI阳性结果为前列腺癌的独立影响因素。 结论 对于存在影响术后Gleason评分升级因素单针阳性患者, 应进行重复穿刺以获得更准确的病理分级,并根据结果及时调整方案。 |
| 英文摘要: |
| 【Abstract】 Objective To investigate the influencing factors for Gleason score upgrading of single-positive-core prostate cancer after radical prostatectomy. Methods A total of 84 single-positive-core prostate cancer patients at the First Hospital of Huzhou from January 2020 to February 2023. Data including age, preoperative serum TPSA, MRI prostate imaging, the biopsy Gleason score, vessel invasion, capsule invasion and positive incision margin were collected. Differences were compared between Gleason score?upgrading group and non-upgrading group, and the influencing factors for Gleason score upgrading were evaluated by univariate and multivariate Logistic regression analysis. Results Of the 84 patients with the single-positive-core prostate cancer, 35 cases had Gleason score upgrading, including 13 cases with Gleason score＜7 and 22 cases with Gleason score≥7. The rate of Gleason score upgrading had statistical differences among the group of TPSA, MRI prostate imaging, and the biopsy Gleason score. The incidences of vessel invasion and capsule invasion had statistically significant differences between the upgrading group and non-upgrading group. The multivariate analysis showed that preoperative TPSA, MRI and the biopsy Gleason score were independent predictors of Gleason score upgrading. Conclusions The treatment plan must be evaluated cautiously for the patients with single-positive-core prostate cancer, and repeated biopsies should be adopted if necessary to adjust the plan accordingly. |
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