根治性前列腺癌切除术后首次血清PSA水平的影响因素分析

张静琦; 周晓洲; 季惠翔; 郑霁; 陈志文

doi:10.16016/j.1000-5404.201903200

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根治性前列腺癌切除术后首次血清PSA水平的影响因素分析

临床医学 | 更新时间：2026-01-09

- 根治性前列腺癌切除术后首次血清PSA水平的影响因素分析
- Analysis of factors affecting first serum prostate specific antigen level after radical prostatectomy for prostate cancer
- 第三军医大学学报 2019年41卷第16期页码：1590-1595
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院泌尿外科，全军泌尿外科研究所
- 作者简介：
  
  [ 陈志文，E-mail:zhiwen@tmmu.edu.cn CHEN Zhiwen, E-mail:zhiwen@tmmu.edu.cn
- 基金信息：
- DOI：10.16016/j.1000-5404.201903200
  中图分类号： R181.23;R446.62;R737.25
- 收稿：2019-03-23，
  
  修回：2019-05-02，
  
  纸质出版：2019-08-30
- 稿件说明：
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张静琦, 周晓洲, 季惠翔, 等. 根治性前列腺癌切除术后首次血清PSA水平的影响因素分析[J]. 第三军医大学学报, 2019,41(16):1590-1595.

Jingqi ZHANG, Xiaozhou ZHOU, Huixiang JI, et al. Analysis of factors affecting first serum prostate specific antigen level after radical prostatectomy for prostate cancer[J]. Journal of Third Military Medical University, 2019, 41(16): 1590-1595.
张静琦, 周晓洲, 季惠翔, 等. 根治性前列腺癌切除术后首次血清PSA水平的影响因素分析[J]. 第三军医大学学报, 2019,41(16):1590-1595. DOI： 10.16016/j.1000-5404.201903200.

Jingqi ZHANG, Xiaozhou ZHOU, Huixiang JI, et al. Analysis of factors affecting first serum prostate specific antigen level after radical prostatectomy for prostate cancer[J]. Journal of Third Military Medical University, 2019, 41(16): 1590-1595. DOI： 10.16016/j.1000-5404.201903200.

摘要

目的

分析影响根治性前列腺癌切除术(radical prostatectomy，RP)后首次血清前列腺特异性抗原(prostate specific antigen，PSA)水平的因素。

方法

回顾性收集2014年1月至2018年5月本科行RP的251例患者的临床病理资料，按照术后6~8周首次血清PSA值是否达到生化复发水平，以0.2 ng/mL为分界点将患者分为PSA < 0.2 ng/mL组和PSA≥0.2 ng/mL组，针对两组患者数据进行单因素分析及多因素Logistic回归分析，筛选出影响RP后首次PSA水平的因素。

结果

① 251例前列腺癌患者:两组患者在BMI、术前有无电切、术前PSA、术后Gleason评分、病理T分期、有无淋巴结清扫、淋巴结清扫数量差异均有统计学意义(

0.05)；多因素Logistic回归分析结果表明BMI、术前PSA、术后Gleason评分、病理T分期为影响术后首次血清PSA水平的独立危险因素；②153例淋巴结清扫的前列腺癌患者:两组在BMI、术前PSA、术后Gleason评分、病理T分期、淋巴结是否阳性、阳性淋巴结数量差异均有统计学意义(

0.05)；多因素Logistic回归分析结果表明术前PSA、淋巴结阳性为影响术后首次血清PSA水平的独立危险因素。

结论

BMI、术前PSA、术后Gleason评分、病理T分期是影响前列腺癌患者术后首次血清PSA水平的独立危险因素；术前PSA和淋巴结阳性是影响淋巴结清扫的前列腺癌患者术后首次血清PSA水平的独立危险因素。

Abstract

Objective

To analyze the factors affecting postoperative first serum prostate specific antigen (PSA) level at 6 weeks in patients receiving radical prostatectomy (RP) for prostate cancer.

Methods

The clinicopathological data were collected retrospectively from 251 patients undergoing RP for prostate cancer in our department between January

2014 and May

2018. According to postoperative first serum PSA levels at 6-8 weeks for assessing biochemical recurrence (with 0.2 ng/mL as the cut-off PSA level)

the patients were divided into PSA < 0.2 ng/mL group and PSA≥0.2 ng/mL group

and univariate analysis and multivariate Logistic regression analysis was performed to identify the factors affecting first serum PSA level after RP.

Results

The two groups of patients with prostate cancer showed significant differences in BMI

history of preoperative electric resection

preoperative PSA level

postoperative Gleason score

pathological T staging

lymph node dissection

and the number of dissected lymph nodes (

0.05). The results of multivariate Logistic regression analysis showed that BMI

preoperative PSA level

postoperative Gleason score and pathological T staging were all independent risk factors affecting postoperative first serum PSA level. In the 153 patients with lymph node dissection

BMI

preoperative PSA level

postoperative Gleason score

pathological T staging

lymph node positivity and the number of positive lymph nodes differed significantly between the patients with postoperative PSA level

0.2 ng/mL at 6 weeks and those with higher PSA levels (

0.05). Multivariate Logistic regression analysis showed that preoperative PSA level and lymph node positivity were independent risk factors that affected the postoperative first serum PSA level.

Conclusion

BMI

preoperative PSA level

postoperative Gleason score and pathologic T staging are all independent risk factors affecting the postoperative first serum PSA level in prostate cancer patients; In patients with lymph node dissection

preoperative PSA level and lymph node positivity are independent risk factors affecting the postoperative first serum PSA level.

关键词

Keywords

references

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