前列腺体积指数与PSA 4-10 ng/m L患者根治术后Gleason评分升级相关性分析

Correlation between Prostate Volume Index and Gleason Score Upgrade after Radical Resection of PSA 4-10 ng/mL

目的分析前列腺体积指数与前列腺特异性抗原(PSA)4-10 ng/mL患者前列腺根治术后Gleason评分(GS)升级的相关性。方法回顾2013年1月至2020年12月,就诊我院162例PSA4-10 ng/mL行根治性切除术患者的临床资料。依据手术前后GS将患者分为升级组,无变化组,降级组,分析3组差异因素,将评分降级组与无变化组合并为未升级组,单因素分析造成术后GS升级的影响因素,再行多因素分析,确定独立预测因素。结果 162例患者,其中99例(61.11%)无变化,6例(3.70%)降级,57例(35.19%)出现GS升级。对比3组患者,PSAD、PV、PVI、活检GS存在统计学差异(P <0.05)。PSAD、PV、PVI、活检GS与评分升级显著相关。PV(OR=0.901,P <0.05)、活检GS=(≤6)(OR=0.045,P <0.05)、PVI(OR=0.012,P <0.05)是前列腺根治术后GS升级的独立预测因子。结论 PSA 4-10 ng/mL前列腺癌患者,PV、PVI、活检GS是根治术后GS升级的独立预测因子,小PV,低PVI,低活检GS的前列腺癌患者,容易出现GS升级。

Objective To analyze the correlation between prostate volume index and Gleason score(GS) after radical prostatectomy in patients with prostate specific antigen(PSA) 4-10 ng/mL. Methods The clinical data of 162 patients with PSA 4-10 ng/mL undergoing radical resection in our hospital from January 2013 to December 2020 were reviewed. According to GS before and after operation, the patients were divided into upgrade group, no change group and degradation group. The difference factors of the three groups were analyzed. The score degradation group and no change group were combined into non upgrade group. The influencing factors of GS upgrade after operation were analyzed by single factor analysis, and then the independent predictive factors were determined by multi factor analysis. Results Among 162 patients, 99(61.11%) had no change, 6(3.70%) were degraded, and 57(35.19%)had GS upgrading. There were significant differences in PSAD, PV, PVI and biopsy GS=(≤6) among the three groups(P<0.05). PSAD, PV, PVI and GS were significantly correlated with score upgrading. PV(OR=0.901, P<0.05), biopsy GS=(≤6)(OR=0.045, P<0.05) and PVI(OR=0.012, P<0.05) were independent predictors of GS upgrading after radical operation. Conclusion In prostate cancer patients with PSA 4-10 ng/mL, PV, PVI and biopsy gs are independent predictors of GS upgrading after radical surgery. Prostate cancer patients with small PV, low PVI and low biopsy gs are prone to GS upgrading.