前列腺电切术后前列腺偶发癌的病理特点及预后分析

Analysis of pathological characteristics and prognosis of incident prostate cancer after resection of prostate

目的探究分析前列腺电切术后前列腺偶发癌(IPCa)的病理特点以及预后情况。方法选取本院2012年9月至2016年9月收治的320例接受经尿道前列腺切除患者作为研究对象;分析和计算320例患者术后前列腺偶发癌发生率,并比较320例良性前列腺增生患者中前列腺偶发癌患者年龄、前列腺体积、术前前列腺特异性抗原等指标。结果320例患者中,术后确诊前列腺偶发癌共18例,检出率为5.63%。前列腺偶发癌以及良性前列腺增生患者年龄等资料比较差异无统计学意义。对18例前列腺偶发癌患者进行骨扫描,未出现病灶转移情况。分期:T1a期6例,T1b期12例。两期Gleason评分比较差异有统计学意义(P<0.05)。两期术前列腺特异性抗原比较差异无统计学意义。年龄等因素与前列腺切除重量比较差异无统计学意义。320例患者均接受最大雄激素阻断治疗,随访时间为(40.23±9.23)个月;6例T1a期患者,术后3、6个月时前列腺特异性抗原下降明显(P<0.05);12例T1b期患者,术后3、6个月时列腺特异性抗原下降明显(P<0.05)。结论前列腺偶发癌发病率为5.63%;通过病理诊断等措施可提高前列腺偶发癌检出率,大多数前列腺偶发癌患者Gleason score评分均在6分左右。表明诊断时掌握患者全部资料,可整体提高临床检出率。

Objective To explore the pathological characteristics and prognosis of incident prostate cancer(IPCa)after prostatectomy.Methods 320 patients who underwent transurethral prostatectomy who were treated in our hospital from September 2012 to September 2016 were selected as the study subjects.The incidence of incident prostate cancer in 320 patients was analyzed and calculated,and then 320 patients with benign prostatic hyperplasia were compared.Among the prostate cancer patients,the age,prostate volume,preoperative prostate-specific antigen and other indicators were compared.Results Among 320 patients,it was found that 18 cases of incident prostate cancer were diagnosed postoperatively,and the detection rate was 5.63%.There was no statistically significant difference in the age of patients with incident prostate cancer and benign prostatic hyperplasia.After analyzing the pathological characteristics of 320 patients,it was found that bone scans were performed on 18 patients with incident prostate cancer,and no metastasis occurred.Staging:6 cases in T1a stage and 12 cases in T1b stage.The difference in Gleason score between the two periods was statistically significant(P<0.05).There was no significant difference in the comparison of prostate specific antigens between the two phases.There was no significant difference in age and other factors compared with the weight of prostatectomy.After analyzing the prognosis of 320 patients,it was found that all 320 patients received the largest androgen block therapy,and the follow-up time was(40.23±9.23)months.In 6 patients with T1a stage,prostate specific antigen decreased significantly at 3 and 6 months after operation(P<0.05).12 patients with T1b stage showed significant decreased in column specific antigen at 3 and 6 months after operation(P<0.05).Conclusion The incidence of incident prostate cancer in this study was 5.63%.The detection rate of incident prostate cancer can be improved by pathological diagnosis and other measures.The Gleason score of most patients with incidental prostate cancer is around 6 scores.Therefore,mastering all the patient's information during diagnosis can improve the overall clinical detection rate.