血脂与根治性前列腺切除术治疗后复发风险的关系

Relationships between blood lipids and the risk of recurrence after radical prostatectomy

目的探讨血脂与根治性前列腺切除术(RP)治疗后复发风险的关系。方法选择行RP治疗的前列腺癌患者161例,其中预后中低风险68例、高风险93例。术后随访3年,生化复发45例、未复发116例。收集所有研究对象的一般资料、实验室检查资料、Gleason评分及临床分期。比较预后中低风险者与高风险者、生化复发者与未复发者上述临床资料,将差异有统计学意义的指标纳入多因素Logistic回归模型,分析行RP治疗患者预后高风险和生化复发的危险因素。结果预后高风险者HDL-C异常率及Lp(a)水平均高于中低风险者(P均<0.05);多因素Logistic回归分析显示,HDL-C异常是行RP治疗患者预后高风险的危险因素(P<0.05)。生化复发者HDL-C、Lp(a)异常率,Lp(a)、PSA水平及Gleason评分≥8分、临床分期≥T2c期比例均高于未复发者(P均<0.05);多因素Logistic回归分析显示,临床分期≥T2c期、高PSA水平和Lp(a)异常是行RP治疗患者生化复发的危险因素(P均<0.05)。结论血脂中HDL-C、Lp(a)异常与行RP治疗患者预后高风险及生化复发有关。

Objective To investigate the relationships between blood lipids and the risk of recurrence after radical prostatectomy(RP).Methods Totally 161 prostate cancer patients undergoing RP were enrolled,including 68 cases of medium-low prognosis risk and 93 cases of high prognosis risk.After a follow-up period of 3 years,biochemical recur-rence was observed in 45 patients while no biochemical recurrence occurred in 116 patients.The general data,laboratory examination results,Gleason score and clinical stage of the subjects were collected.A comparison of the collected data was made between the medium-low risk group and the high-risk group,as well as between the biochemical recurrence group and the non-recurrence group.Indexes with statistically significant differences were included in the multivariate Logistic regression model to identify the risk factors associated with high prognosis risk and biochemical recurrence.Results Compared with the medium-low risk group,the high-risk group exhibited a higher abnormal rate of HDL-C and an elevated level of Lp(a)(both P<0.05).Multivariate Logistic regression analysis revealed that abnormal HDL-C level was a high risk factor for prognosis of patients after RP(P<0.05).The abnormal rates of HDL-C and Lp(a),the levels of Lp(a)and PSA,the proportions of Gleason score≥8 and clinical stage≥T2c were higher in the recurrence group than in the non-recurrence group(all P<0.05).Multivariate Logistic regression analysis showed that high-grade clinical stage(≥T2c),elevated PSA level and abnormal Lp(a)level were risk factors for recurrence in patients undergoing RP(all P<0.05).Conclusions The abnormal serum HDL-C and Lp(a)are associated with the high prognosis risk and biochemi-cal recurrence in patients undergoing RP.