前列腺根治术前肥胖相关的生化指标对前列腺癌患者预后的意义

Prognostic significance of obesity-related biochemical indices in patients with prostate cancer before radical prostatectomy

目的:探讨前列腺癌根治术(RP)前肥胖相关生化指标[总胆汁酸、空腹血糖(FBG)、血尿酸、总胆固醇、甘油三酯、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]预测前列腺癌患者预后的价值。方法:选取635例前列腺癌手术患者,根据指南分为低、中、高危三组,在RP前检测并收集其肥胖相关生化指标。根据各指标的正常值,将各组前列腺癌患者分别分为偏高组与非偏高组。采用χ^(2)检验评价各指标组间差异,采用Kaplan-Meier生存曲线分析前列腺癌患者的生存曲线,并用Cox回归分析评估各项指标对前列腺癌手术患者预后的价值。结果:Kaplan-Meier分析显示,无论是1年总生存率(OS)或肿瘤特异性生存率(CSS),高总胆汁酸、高FBG、高血尿酸和高LDL的患者的死亡率均明显高于非偏高组患者(P<0.05)。Cox回归分析结果显示,高总胆汁酸、高FBG是前列腺癌患者OS、CSS的独立危险因素(P<0.05),而低HDL仅是前列腺癌患者CSS的独立危险因素,并且总胆固醇与前列腺癌患者预后无关。结论:术前总胆汁酸、FBG可作为预测前列腺癌手术患者预后的独立指标,高总胆汁酸、高FBG的前列腺癌患者在接受手术后预后较差。

Objective:To investigate the roles of pretreatment obesity-related biochemical markers[total bile acid,fasting blood glucose(FBG),blood uric acid,total cholesterol,triglyceride,high-density lipoprotein(HDL),low-density lipoprotein(LDL)]in the prognosis of prostate cancer patients.Methods:Six hundred and thirty-five patients with prostate cancer which were treated by surgery were enrolled.According to the guidelines,patients were divided into three groups,low,medium and high risk.Obesity-related biochemical markers were determined and gathered before radical prostatectomy.According to the normal value of each marker,each group of prostate cancer patients were divided into high group and non-high group.Chi-square test was used for the intergroup difference among various indicators.Kaplan-Meier method was used for survival analysis,and Cox regression analysis was used to evaluate the prognostic value of each index in patients with prostate cancer of surgery.Results:Kaplan-Meier analysis showed that,whether it is 1-year overall survival rate(OS)or cancer specific survival rate(CSS),patients with high total bile acid,high FBG,high serum uric acid and high LDL have a significantly higher mortality than those patients in non-high group(P<0.05).Cox regression analysis showed that total bile acid and FBG were independent risk factors for OS and CSS in prostate cancer patients(P<0.05).However,Low HDL was only independent risk factor for CSS in prostate cancer patients.Furthermore,Triglyceride is not associated with prognosis in prostate cancer patients.Conculsion:Total bile acid and FBG can be used as independent indicators to predict the prognosis of patients undergoing radical prostatectomy.Patients with high total bile acid and high FBG have a poor prognosis after surgery.