激素敏感转移性前列腺癌的临床预后因素研究

Study on the Clinical Prognostic Factors of Hormone-sensitive Metastatic Prostate Cancer

目的探讨激素敏感转移性前列腺癌发展为去势抵抗性前列腺癌(CRPC)的独立预后因素。方法回顾性分析72例激素敏感转移性前列腺癌患者的临床病例资料,分析年龄、基线前列腺特异性抗原(PSA)、前列腺腺癌组织学分级Gleason评分、内脏及四肢的骨转移状况、血色素(HGB)及碱性磷酸酶(ALP)与患者预后的相关性。结果最后一次随访发现,25例患者进展为CRPC,47例患者仍给予内分泌治疗。患者有35个月的中位无进展生存时间,1年、2年、3年的无进展生存率分别为83.33%、56.94%、41.67%。经单因素和多因素分析发现,激素敏感转移性前列腺癌发展为去势抵抗性前列腺癌的独立预后因素包括基线血清PSA值、碱性磷酸酶、Gleason评分、内脏转移以及四肢骨转移。结论基线血清PSA值、碱性磷酸酶、Gleason评分、内脏转移、四肢骨转移是激素敏感转移性前列腺癌进展为去势抵抗性前列腺癌的独立预后因素。

Objective To explore the independent prognostic factors of hormone-sensitive prostate cancer into ovariectomized prostate cancer. Methods Retrospective analysis of 72 patients with hormone-sensitive metastatic prostate cancer were conducted,analysis of age,baseline prostate specific antigen（ PSA）,prostate adenocarcinoma histological grading Gleason score,visceral and limb bone metastases,hemoglobin（ HGB） and alkaline phosphatase（ ALP） and the prognosis of patients were conducted. Results During the last follow-up,25 patients developed CRPC and 47 patients were given endocrine therapy. Patients had 35 months of median progression-free survival,and 1-,2-,and 3-year progression-free survival rates were 83. 33%,56. 94% and 41. 67%,respectively. Univariate and multivariate analysis showed that the independent prognostic factors for the development of hormone-sensitive metastatic prostate cancer into castrated prostate cancer included baseline serum PSA,alkaline phosphatase,Gleason score,visceral metastasis,and limb bone metastases. Conclusion Baseline serum PSA,ALP,Gleason score,visceral metastasis,limb bone metastasis are independent prognostic factors for hormone-sensitive metastatic prostate cancer progression to ovariectomized prostate cancer.