治疗前睾酮水平与前列腺癌预后因素相关性的初步研究

Primary study on the relationship of pre-therapy testosterone and prognositic factors of prostate adenocarcinoma

目的探讨治疗前睾酮与前列腺癌(PCa)预后因素的相关性。方法同顾性分析175例PCa患者临床资料,用SPSS 11.0统计软件分别比较不同临床分期、病理分级患者睾酮值的差异,分析睾酮与若干PCa预后因素的相关性。结果治疗前睾酮与治疗前总PSA、穿刺活检点数阳性率呈明显负相关,相关系数分别为-0.298(P<0.01)和-0.385(P<0.01);切缘阳性患者的睾酮值明显低于切缘阴性者(P<0.01);淋巴结转移患者的睾酮值显著低于未转移患者(P<0.01);不同病理分级和临床分期之间睾酮比较差异具统计学意义(P均<0.01)。结论在PCa患者中,治疗前睾酮水平较低者预后不良。低睾酮可能为晚期和(或)侵袭性较强的PCa的表现。

Objective To analyze the relationship of pre-therapy testosterone and the prognositic factors of prostate adenocarcinoma. Methods Clinical information of 175 patients with prostate adenocarcinoma was retrospecvtively reviewed including age, height, weight, pre-therapy prostate specific antigen, pre-therapy testosterone, size of prostate and percentage of positive biopsies（PPBs） at diagnosis of prostate adenocarcinoma. Outcomes of radical prostatectomy such as positive edge, Gleason score of surgical specimen and lymph node metastasis were also summarized, and then the relationship of pre-therapy testosterone with the prognositic factors of prostate adenocarcinoma was analyzed. Results Pre-therapy testosterone was negatively correlated to total PSA （correlation coefficient, -0.298, P〈0.01 ）and PPBs （correlation coefficient, -0.385, P〈0.01）, the level of testosterone in patients with positive surgical edge was lower than that in patients with the negative edge （P〈0.01）, and the level of testosterone in patients with lymph node metastasis was also lower than that in patients with non metastasis （P〈0.01）. There were significant differences in the level of testosterone among groups with different clinical stages （P〈0.01） and with different pathological grade （P〈0.01）. Conclusion Patients with low level of pre-therapy testosterone had a poor prognosis after radical prostatectomy. Low level of testosterone might be a clinical characteristic of late-stage and/or more invasive prostate adenocarcinoma.