血清脂肪细胞因子与前列腺癌根治性切除术后复发的相关性

Correlation between serum adipocytokines and recurrence after radical resection of prostate cancer

目的观察前列腺癌根治性切除术(RP)后复发情况,并分析血清脂肪细胞因子与复发的相关性,为前列腺癌复发风险的科学预测提供理论依据。方法选取该院2014年1月至2016年1月收治的252例前列腺癌患者作为研究对象,均接受RP治疗,RP术后平均随访时间(45.52±2.34)个月,检测患者血清脂肪细胞因子水平,记录RP术后复发情况,分析血清脂肪细胞因子水平与RP术后复发的相关性。结果252例前列腺癌患者RP术后随访期间复发率为30.95%;RP术后复发患者的术前格里森评分(GS)评分≥8分占比、术前血清前列腺特异性抗原(PSA)>20 ng/mL占比、手术病理检查分期T3期占比、术前瘦素(Leptin)及脂联素(ADPN)水平均高于RP术后未复发患者,差异均有统计学意义(P<0.05);经单因素Logistic回归分析后建立多元回归模型,多因素分析结果显示,前列腺癌患者术前GS评分、术前PSA水平、手术病理检查分期、术前Leptin及ADPN表达是RP术后复发的影响因素(OR>1,P<0.05);受试者工作特征曲线(ROC)分析发现,前列腺癌患者术前Leptin及ADPN水平单项检测及联合检测用于预测RP术后复发风险的曲线下面积(AUC)均大于0.800,均有一定预测价值,且在Leptin、ADPN cut-off值分别取17.085 ng/mL、30.070 ng/mL时,可获得最佳预测价值。结论前列腺癌患者RP术治疗后复发风险高,术前GS评分、PSA水平、手术病理检查分期、血清脂肪细胞因子均与术后复发风险存在密切关系,可将患者术前血清Leptin及ADPN表达作为RP术后复发风险的有效预测指标,指导早期干预。

Objective To observe the recurrence of prostate cancer after radical resection(RP),and to analyze the correlation between serum adipocytokines and recurrence,so as to provide theoretical basis for scientific prediction of recurrence risk of prostate cancer.Methods A total of 252 cases of prostate cancer patients admitted to the hospital from January 2014 to January 2016 were selected as the research subjects.All patients received RP surgery.The average postoperative follow-up time of RP was(45.52±2.34)months.The correlation between serum adipocytokine level and postoperative recurrence of RP was analyzed.Results The recurrence rate of 252 patients with prostate cancer during the follow-up period after RP was 30.95%.The preoperative Gleeson score(GS)score≥8 points,the preoperative serum prostate-specific antigen(PSA)>20 ng/mL,the preoperative pathological examination stage T3 proportion,and the preoperative Leptin and adiponectin(ADPN)levels were all significantly higher than those of the patients without RP recurrence(P<0.05).A multivariate regression model was established after univariate Logistic regression analysis.The results of multivariate analysis showed that preoperative GS score,preoperative PSA level,stage of surgical pathological examination,preoperative Leptin and ADPN expression were the influencing factors of postoperative recurrence of RP(OR>1,P<0.05).Receiver operating characteristic curve(ROC)analysis showed that the area under the curve(AUC)of preoperative Leptin and ADPN for predicting the risk of postoperative recurrence in prostate cancer patients was over 0.800 for both single and combined tests,which had certain predictive value.The best predictive value was obtained when the cut-off values of Leptin and ADPN were 17.085 ng/mL and 30.070 ng/mL,respectively.Conclusion Patients with prostate cancer have a high risk of recurrence after RP surgery.Preoperative GS score,PSA level,stage of surgical pathological examination and serum adipocytokines are closely related to the risk of recurrence after RP surgery.Preoperative serum Leptin and ADPN expression can be used as an effective predictor of the risk of recurrence after RP surgery to guide early intervention.