代谢综合征对前列腺癌术后生化复发的影响:一项竞争风险分析

The impact of metabolic syndrome on the biochemical recurrence of prostate cancer after radicalprostatectomy:a competing risk analysis

目的评估代谢综合征(MS)对前列腺根治性切除术后生化复发的影响。方法回顾性分析2007年11月至2016年3月于北京大学第一医院泌尿外科接受前列腺根治性切除术的患者资料。根据有无合并MS分为两组,卡方检验比较两组的临床病理参数的差异,竞争风险模型分析前列腺癌患者术后生化复发的危险因素。结果共有367例前列腺癌患者纳入研究,其中合并MS的患者有59(16.08%)例。MS和前列腺癌的病理T分期以及周围神经浸润有明显相关性。随访期间,17(4.63%)例患者死亡,75(20.44%)例患者出现生化复发。多因素竞争风险模型分析结果提示MS(风险比HR:1.859,95%置信区间CI:1.121～3.083,P=0.016)是前列腺癌术后生化复发的独立危险因素。结论 MS与前列腺癌的病理T分期以及周围神经浸润密切相关,并可以独立预测前列腺根治性切除术后生化复发的风险。

Objective To evaluate the effect of metabolic syndrome(MS)on the biochemical recurrence of prostate cancer after radical prostatectomy.Methods Clinicopathological data of patients who underwent radical prostatectomy in the First Hospital of Peking University during Nov.2007 and March 2016 were retrospectively analyzed.The patients were divided into MS group and non-MS group.The clinicopathological parameters of the two groups were compared with Chi-square test.The risk factors of biochemical recurrence after radical prostatectomy were analyzed with a competing risk model.Results A total of 367 patients were enrolled,including 59(16.08%)in the MS group and 308(83.92)in the non-MS group.MS was significantly associated with the pathological stage and perineural invasion.During the follow-up,17(4.63%)patients died and 75(20.44%)developed biochemical recurrence.The results of multivariate competing risk analysis indicated that MS(HR:1.859,95%CI:1.121-3.083,P=0.016)was an independent risk factor of biochemical recurrence after radical prostatectomy.Conclusions MS is closely related to the pathological stage and perineural invasion of prostate cancer,and is able to independently predict the risk of biochemical recurrence after radical prostatectomy.