前列腺切除术中前列腺偶发癌的检出率及预后影响因素分析

摘要

Objective To investigate the incidentally discovered prostate cancer detection rate and prognostic factors of prostate hyperplasia surgery patients.Methods 4387 cases of prostate hyperplasia surgery patients were selected as the research objects.There were 375 incidentally discovered prostate cancer patients.The author consulted a large number of references and then make the self~made questionnaire in order to collect the clinical data.They were analyzed by descriptive statistical methods and logistic regression analysis of SPSS18.0 statistical software package in order to find out the incidentally discovered prostate cancer detection rate and prognostic factors of prostate hyperplasia surgery patients.Results The detection rate of incidental prostate cancer after the prostatectomy was 8.55%(375/4387).Binary classification logistic regression analysis showed that age(β=1.68,95.0% CI=3.15~9.23),Gleason scores(β=1.58,95.0% CI=3.30~7.08),differentiated degree(β=1.87,95.0% CI=3.29~13.03),lymph node metastasis(β=3.04,95.0% CI=5.50~79.82),serum PSA level(β=1.90,95.0% CI=2.05~22.01) and clinical stages(β=0.83,95.0% CI=1.35~3.90) were risk factors for the prognosis of incidental prostate cancer after the prostatectomy.Conclusion The detection rate of incidental prostate cancer after the prostatectomy is high.The elderly,clinical stage,anxiety,depression,lymph node metastasis are risk factors for the prognosis of incidental prostate cancer after the prostatectomy.Therefore,we need more vigilant about accidental prostate carcinoma for the high-risk groups.Early detection,early diagnosis,and early treatment can improve the prognosis of patients.%目的 探讨前列腺切除术中前列腺偶发癌的检出率及预后影响因素.方法 选取4387例前列腺增生症手术患者为研究对象.其中,前列腺偶发癌有375例,笔者查阅大量参考文献后制定自编问卷并将其应用于收集前列腺偶发癌患者的临床资料,采用SPSS18.0统计软件包进行描述性统计方法和Logistic回归分析法分析收集到的临床资料,以期找出前列腺切除术中前列腺偶发癌预后影响因素.结果 前列腺切除术中前列腺偶发癌检出率为8.55%(375/4387).Logistic回归分析,结果发现:年龄(β=1.68,95.0% CI=3.15~9.23)、Gleason评分(β=1.58,95.0% CI=3.30~7.08)、分化程度(β=1.87,95.0% CI=3.29~13.03)、淋巴结转移(β=3.04,95.0% CI=5.50~79.82)、血清PSA(β=1.90,95.0% CI=2.05~22.01)、临床分期(β=0.83,95.0% CI=1.35~3.90)是前列腺切除术中前列腺偶发癌预后的危险因素.结论 前列腺切除术中前列腺偶发癌检出率较高,老年、临床分期、血清PSA水平及其淋巴结转移是影响前列腺切除术中前列腺偶发癌预后的危险因子.在对前列腺增生症患者进行治疗时,应针对高危人群高度警惕前列腺偶发癌,做到早发现、早诊断并早治疗.