前列腺癌根治术后标本较穿刺标本Gleason评分上升的影响因素分析
发布时间:2018-05-12 04:32
本文选题:前列腺根治术 + 穿刺 ; 参考:《福建医科大学》2014年硕士论文
【摘要】:目的探讨前列腺根治术后标本较前列腺穿刺活检标本Gleason评分上升的影响因素。方法文章回顾性分析了2010年1月~2013年12月间我院164例接受前列腺穿刺活检及根治性前列腺切除的前列腺癌患者年龄、术前血清PSA值、前列腺体积、PSAD、活检标本及根治术后标本Gleason评分、穿刺至手术间隔时间、穿刺阳性针数、切缘阳性率、精囊侵犯、淋巴转移等指标。所有患者分为Gleason评分升高组和非升高组,运用Logistic单因素及多因素回归分析等统计学方法比较分析引起根治术标本Gleason评分上升的相关影响因素。结果164例患者中中95例(57.93%)活检标本和根治术后标本Gleason评分一致,55例(33.54%)根治术后标本Gleason评分上升,,14例(8.52%)根治术后标本Gleason评分下降。单因素分析得出前列腺体积、PSAD、穿刺阳性针数、穿刺评分具统计学意义(P0.05),而其余年龄、术前PSA水平、临床分期、切缘阳性率、精囊侵犯、淋巴转移、穿刺至手术间隔时间则无显著相关性(P0.05)。多因素Logistic回归分析提示前列腺体积(P0.001)及穿刺评分(P=0.032)是影响根治术后标本Gleason评分上升的独立预测因子。结论前列腺体积越小及Gleason评分≤6的前列腺癌患者其术后标本Gleason评分升高可能性越大。
[Abstract]:Objective to investigate the factors influencing the Gleason score of prostate biopsy specimens after radical prostatectomy. Methods from January 2010 to December 2013, 164 patients with prostate cancer underwent prostate biopsy and radical prostatectomy were analyzed retrospectively. The preoperative serum PSA values were analyzed retrospectively. Prostate volume, Gleason score of biopsy specimen and post-operation specimen, time between puncture and operation, number of positive needle puncture, positive rate of incision margin, invasion of seminal vesicle, lymphatic metastasis and so on. All the patients were divided into two groups: Gleason score increased group and non-elevated group. Univariate and multivariate regression analysis of Logistic were used to compare and analyze the related factors that caused the increase of Gleason score in radical operation specimens. Results the Gleason score of the biopsy specimens was the same as that of the specimens after radical operation in 95 of 164 patients (57.93). The Gleason score of the specimens increased in 14 patients after radical operation. The Gleason score of the specimens decreased after radical operation. Univariate analysis showed that the prostate volume, the number of positive needle puncture, the score of puncture were statistically significant (P 0.05), while the other age, preoperative PSA level, clinical stage, positive rate of incision margin, seminal vesicle invasion, lymphatic metastasis, There was no significant correlation between puncture and operation interval (P 0.05). Multivariate Logistic regression analysis showed that prostatic volume (P0.001) and puncture score (P0.032) were independent predictors of the increase of Gleason score after radical operation. Conclusion the smaller the prostate volume and the greater the Gleason score 鈮
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