影响前列腺癌根治性切除术后首次血清PSA水平的因素分析

Analysis of factors affecting the first serum PSA level after radical prostatic cancer resection

目的:探讨影响前列腺癌根治性切除术后首次血清前列腺特异性抗原(PSA)水平的因素。方法:选择2015年1月—2021年8月在北部战区总医院行根治性切除术的前列腺癌患者251例进行回顾性分析。收集前列腺癌根治性切除术后首次血清PSA水平的可能因素,根据患者术后6~8周时首次PSA检查结果将患者分为PSA<0.2ng/mL组和PSA≥0.2ng/mL组,比较2组患者各项临床指标,并采用二元多因素logistic回归法评估各因素对前列腺癌患者根治性切除术后首次PSA水平的综合作用。结果:251例患者共56例患者血清PSA≥0.2ng/mL。多因素分析结果显示,BMI增加、T分期为Ⅲ~Ⅳ期、术前PSA水平升高、精囊侵犯及神经侵犯为前列腺癌根治性切除术后首次血清PSA水平升高的危险因素(P<0.05)。结论:前列腺癌根治性切除术后首次血清PSA水平主要受患者BMI、T分期、术前PSA水平、精囊侵犯情况及神经侵犯情况的影响。

Objective:To investigate the factors that affect the first serum PSA level after radical prostate cancer resection.Methods:Two hundred and fifty-one prostate cancer patients who underwent radical resection in Northern Theater General Hospital from January 2015to August 2021were selected for retrospective analysis.The clinical data that may affect the changes of PSA level in the first serum after radical prostatectomy were collected.According to the results of the first PSA examination at 6-8weeks after operation,the patients were divided into PSA<0.2ng/mL group and PSA≥0.2ng/mL group,and the clinical treatment of the two groups were compared.The comprehensive effect of various factors on PSA level after radical resection was evaluated by the binary logistic regression method.Results:A total of 56patients from 251patients had serum PSA≥0.2ng/mL.The results of multivariate analysis showed that:increased BMI index,T stage ofⅢ-Ⅳ,increased pre-PSA level,seminal vesicle invasion and nerve invasion were the risk factors for increased PSA level after radical prostatectomy(P<0.05).Conclusion:The first serum PSA level after radical prostate cancer resection is mainly affected by the patient's BMI index,T stage,preoperative PSA level,seminal vesicle invasion and nerve invasion.