前列腺癌根治术治疗不同分级前列腺癌患者的临床研究

Clinical Study of Radical Prostatectomy in Treatment of Patients with Different Grade of Prostate Cancer

目的:探究前列腺癌根治术在不同危险度前列腺癌患者中治疗的临床效果,为临床前列腺癌患者的治疗提供依据。方法:选择2008年1月~2015年12月期间我院94例前列腺癌患者为研究对象,根据D'Amico评分将其分为高危、中危及低危三组,收集患者基线资料、术后随访资料,并比较三组手术并发症;采用Kaplan-Meier分析法计算三组患者生存率,并采用Log-rank检验比较不同危险组的生存率。结果:高危组患者进行开放性手术人数多于中危组和低危组,且中危组多于低危组,差异具有统计学意义(P<0.05);高危组患者术前Gleason评分和PAS水平高于中危组和低危组,且中危组高于低危组,差异具有统计学意义(P<0.05);术后5年高危组患者完全控尿率显著低于中危组和低危组(P<0.05);三组患者间5年无生化复发率比较无统计学意义(P>0.05)。结论:前列腺癌根治术治疗高危前列腺患者较中、低危患者疗效较差,但仍可达到较好的疗效,可在临床推广使用。

Objective： To explore the clinical effect of radical prostatectomy in the treatment of patients with different risk of prostate cancer,and to provide the basis for clinical treatment of prostate cancer. Methods： Selected 94 cases of Patients with prostate cancer who treated with radical mastectomy in our hospital from January 2008 to December 2010 as the research object,which were divided into high-risk,medium-risk and low-risk group according to the score of Amico ＇D. Collected the baseline data and follow-up data of patients and compared the complications of surgical among three groups; calculated the rate of survival by Kaplan Meier method,and compared the survival rate in different risk groups by log rank test. Results： The number of open surgery patients in high risk group were more than that in the medium and low risk groups,and the middle group was more than lower risk groups,the differences were statistically significant（P〈0.05）; Preoperative Gleason score and PAS level in high-risk group were higher than those in the medium and low risk groups,and the medium risk group was higher than those in the low risk group,the differences were statistically significant（P〈0.05）. The rate of complete control of urine after 5 years of surgery in high-risk group was significant lower than that of the medium and low risk groups（P〈0.05）; There was no significant statistical significance between the three groups of patients with no recurrence rate for 5 years（P〈0.05）. Conclusion： The efficacy of radical prostatectomy in the treatment of prostate cancer patients with high risk is poorer than the middle and lower risk patients,but it still has a good efficacy,which can be used in clinical promotion.