晚期前列腺癌药物去势中Gleason评分、血清PSA与疗效相关性研究

A relative analysis on the efficacy of medical castration in the treatment of metastatic prostate cancer patients to Gleason score and serum PSA level

目的：探讨晚期前列腺癌（Pca）患者药物去势治疗过程中疗效与Gleason评分及血清前列腺特异性抗原（PSA）的相关性。方法：选择33例晚期Pca患者，给予黄体激素释放激素类似物（LHRH—A）＋抗雄激素药物进行药物去势治疗，根据Gleason评分分为2～5分组、6～7分组、8～10分组，对3组血清PSA变化进行分析。结呆：Gleason评分6～7分组的病人在治疗后3个月内血清PSA值下降最快，治疗后6个月时Gleason评分2～5分组病人血清PSA值恢复正常，而Gleason评分6～7分组与8～10分组病人血清PSA值则接近正常值范围。不同Gleason评分组间血清PSA水平差异有统计学意义（F=5．396，P〈O．05）。结论：（1）Gleason评分、血清PSA水平与晚期Pca患者行药物去势疗法疗效有密切关系。（2）血清PSA变化是监测Pca复发与评价疗效的可靠瘤标。

Objective. To probe into the correlation of Gleason score and serum PSA level during medical castration in metastatic prostate cancer patients. Methods. We treated metastatic prostate cancer patients with luteinizing hormone-releasing hormone analog, （LHRH-A） and androgen ablation drug （Flutamide）, and combined with the change of Gleason score and serum PSA level, We have a statistical analysis elevate the efficacy of treatment. Results. The levels of the serum PSA during the treatment significantly decreased in 3 months among the groups of Gleason score between 6-7. The level of the serum PSA during the treatment returned to normal in 6 months among the groups of Gleason score between 2-5, but the groups of Gleason score between 6-7 and 8-10 were near to normal and the level of serum of PSA among different groups of Gleason score with significantly different （F = 5. 396, P 〈0.05）. Statistically signifi- cant differences were found in those. Conclusions： （1） The Gleason score and the level of the serum PSA have a close relation to the efficacy of medical castration in the treatment of metastatic prostate cancer patients. （2）The change of PSA level is a valuable marker for watching the recurrent and effective of tumor.