前列腺癌患者前列腺体积与肿瘤分级之间关系探讨

目的:探讨国人前列腺癌患者前列腺体积与肿瘤分级之间的关系。方法:回顾我院及武汉大学人民医院2005年1月-2011年10月70例确诊为前列腺癌并行根治性前列腺切除术(RP)患者的临床病理资料,采用SPSS13.0软件总结并分析前列腺癌患者前列腺体积与肿瘤分级之间的关系。结果:经直肠前列腺穿刺活检获得肿瘤病理分级与根治性前列切除术获得最终病理分级具有显著差异(P=0.003);在活检及根治性前列腺切除标本中,前列腺体积与高级别肿瘤发生率均呈负相关(P<0.05);小前列腺与阳性手术切缘、前列腺外侵犯及高级别肿瘤在单变量分析中具有相关性(P<0.05),而与精囊腺侵犯及淋巴结侵犯则无相关性(P>0.05);在校正了年龄、体重指数及术前前列腺特异性抗原水平后,前列腺体积与阳性手术切缘、前列腺外侵犯、精囊腺侵犯及高级别肿瘤发生率均呈负相关(OR<1,P<0.05),而与淋巴结侵犯则无相关性(P>0.05)。结论:前列腺体积是高级别前列腺癌的重要预测因子,利用其对高级别肿瘤风险的预测能力可帮助选择最佳治疗方案并进一步提高治疗效果。

Exploration on the Association of Prostate Volume and Tumor Grade in Patients of Prostate Cancer

Objective: To explore the association of prostate volume and tumor grade in patients of prostate cancer in Chinese.Methods: Clinical data of 70 patients who were diagnosed with prostate cancer and underwent radical prostatectomy between Jan 2005 and Oct 2011 were collected.The correlation of prostate volume with tumor grade were analyzed with SPSS 13.0 statistical software.Results: The pathological grade of tumor in biopsy specimens was statistically different with the final pathological grade in radical prostectomy specimens(P<0.05).Prostate volume had an inverse relationship with high grade tumor in both biopsy and radical prostectomy specimens.Small prostate volume was associated with high grade prostate cancer as well as positive surgical margin and extraprostatic extension but not with seminal vesicle invasion and lymph node involvement on univariate analysis.On multivariate analysis adjusted for age,body mass index(BMI) and prostate specific antigen(PSA) prostate volume had an strong correlationship with high grade tumor(OR 0.32;95% CI 0.18,0.56 per 1 milliliter,P<0.05),positive surgical margin(OR 0.35;95% CI 0.21,0.53 per 1 milliliter,P<0.05),extraprostatic extension(OR 0.28;95% CI 0.14,0.57 per 1 milliliter,P<0.05) and seminal vesicle invasion(OR 0.37;95% CI 0.17,0.81 per 1 milliliter,P<0.05).Conclusion: Prostate volume is an important predictor of high grade prostate cancer.The ability to predict high grade disease is in favor of selecting the best therapeutic regime and improving the efficacy of treatment.