多因素分析前列腺癌无进展生存期及其临床指导价值探讨

李忠海，王英磊，曹现祥，曹先德，赵占魁，孟琳，肖琳，范成娟

（济宁医学院附属医院泌尿外科，山东 济宁，272029）

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摘要：

目的 探讨影响前列腺癌患者内分泌治疗后无进展生存期的相关因素，为临床治疗前列腺癌及延长患者的生存期提供参考。方法 对本院119例接受内分泌治疗的前列腺癌患者进行回顾性分析，根据患者内分泌治疗开始后24个月内是否进展为雄激素非依赖性前列腺癌分为进展组72例、未进展组47例，采用多因素分析方法分析其相关因素。结果进展组的治疗前血清PSA≧50 μg/L、Gleason 评分>7 分、单独手术/药物去势比例、临床分期中T3分期患者的比例、发生淋巴结转移患者的比例均显著高于未进展组患者，且差异均具有统计学意义（P<0.05）；两组患者的年龄构成比较，差异无统计学意义（P> 0.05）。Logistic回归模型结果显示：治疗前血清PSA（OR=2.981）、Gleason 评分（OR=2.615）、临床分期（OR=1.783）、淋巴结转移（OR=1.919）是前列腺癌患者内分泌治疗后无进展生存期的缩短的主要危险因素（P<0.05）。结论 患者治疗前血清PSA水平高、Gleason 评分较高、临床分期晚、淋巴结转移是影响前列腺癌患者内分泌治疗后无进展生存期的重要危险因素。

关键词：前列腺癌；内分泌治疗；无进展生存期；相关因素分析

中图分类号：R737.5文献标志码：A文章编号：2096-1413(2017)03-0006-03

Exploration of multivariate analysis of progression-free survival time of prostate

cancer and its clinical value
LI Zhong-hai, WANG Ying-lei, CAO Xian-xiang, CAO Xian-de, ZHAO Zhan-kui,
MENG Lin, XIAO Lin, FAN Cheng-juan
(Department of Urology Surgery, the Affiliated Hospital of Jining Medical College, Jining 272029, China)

ABSTRACT: Objective To analyze the factors that influence the progression-free survival time of prostate cancer patients after endocrine therapy, and to provide references for clinical treatment of prostate cancer and prolonging the survival time of patients. Methods One hundred and nineteen cases of prostate cancer patients who received endocrine therapy in our hospital were retrospectively analyzed. All patients were divided into progress group (72 cases) and non-progression group (47 cases) according to whether the patients progressed to androgen independent prostate cancer within 24 months' endocrine therapy. Then multivariate analysis was used to analyze the correlation factors. Results The proportion of serum PSA≧50 μg/L, Gleason score >7, separate operation and medication, amount of patients in T3 stage and lymph node metastasis in the progress group before treatment were obviously higher than those in the non -progression group, the differences between the two groups were statistically significant (P <0.05). The age ratio of the two groups was not statistically significant (P>0.05). Logistic regression results showed that the serum PSA (OR=2.981), Gleason score (OR=2.615), clinical stage (OR=1.783), lymph node metastasis ratio (OR=1.919) before treatment were major risk factors to shorten progression-free survival time of prostate cancer patients after endocrine therapy (P<0.05). Conclusion The high level of serum PSA, high Gleason score, late clinical stage and lymph node metastasis ratio are the important risk factors  for the progression-free survival time of prostate cancer patients after endocrine therapy.
KEYWORDS: prostate cancer; endocrine therapy; progression-free survival time; correlation factor analysis

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