前列腺癌患者202例临床分析

Clinical analysis of prostate cancer:a report of 202 cases

目的研究前列腺癌的诊疗现状及影响前列腺癌患者预后的因素。方法将我院近10年收治的202名前列腺癌患者以规范开展PSA检查时间分为两组,1997-01～2001-12为第一组,2002-01～2007-07为第二组,对两组间年龄分布、病理分级和临床分期的分布进行比较。并对其中126例病理分级和临床分期完整且随访1年以上的患者进行生存分析。结果第一组收治前列腺癌患者35例,第二组收治前列腺癌患者167例,第二组是第一组的4.77倍;两组间年龄分布、病理分级构成比差别无统计学意义(P>0.05),两组间临床分期构成比差别有统计学意义(χ2=3.999,P<0.05),第二组早期患者明显增加。126例前列腺癌患者1年、3年、5年的总生存率分别为:88.24%,61.74%和22.8%;生存分析显示早期患者的生存率明显高于晚期患者(χ2=9.223,P<0.05),低分化患者的生存率明显比中分化和高分化低(χ2值分别为4.143,4.646,P<0.05),中分化和高分化患者生存率差别无统计学意义(χ2=0.172,P>0.05),发病年龄大于70岁的生存率较小于70岁高(χ2=6.533,P<0.05)。结论前列腺癌的发病趋势明显增加,规范的PSA检查有助于早期诊断前列腺癌。临床分期和病理分级是影响预后的主要因素。

Objective To study the present situations of diagnosis and treatment of prostate cancer, and to explore the influential factors of its prognosis. Methods The clinical data of 202 patients with prostate cancer in recent 10 years were retrospectively analyzed. The patients were divided into two groups by the time of standard PSA test（2002） ：group Ⅰ （1997 -01- 2001 - 12）and group Ⅱ （2002- 01--2007- 07）. Overall survival for 126 patients with different age, stage and grade were analyzed by Kaplan-Meier method. Results The numbers of patients with prostate cancer in group Ⅰ （ n = 167）were as 4.77 times as that in group Ⅱ （ n = 35）. There was no statistical difference in age distribution and the proportion of pathological grade between two groups（ P 〉 0.05）. Whereas there was significant difference in the proportion of different clinical stage between two groups（x^2 = 3. 999, P〈0.05）. Survival rates of 126 patients at 1,3,5 years were 88.24 %, 61.74 % and 22.8 %, respectively. The survival rate of these advanced stage patients was lower than that of earlier stage（x^2 = 9. 223, P 〈 0.05）. The survival rate of these patients with poorly differentiated was lower than those with moderately differentiated and well differentiated（x^2 = 4. 143,4. 646, P 〈 0.05）, but there was no statistical difference between the patients with moderately differentiated and well differentiated（x^2 = 0. 172, P 〉0.05）. The survival rate of these patients over 70 years old was significantly higher than those of the younger（x^2 = 6. 533, P 〈 0.05）. Conclusion The clinical incidence of prostate cancer is markedly increasing in recent years. Regular PSA examination could help to early diagnose patients. Clinical stage and pathological grade are major factors to influence the survival rate of prostate cancer.