前列腺癌根治术联合间断抗雄激素对前列腺癌患者肿瘤标志物及疾病预后的影响

Effect of Radical Prostatectomy Combined with Intermittent Antiandrogen on Tumor Markers and Disease Prognosis of Prostate Cancer Patients

目的:探讨前列腺癌根治术联合间断抗雄激素对前列腺癌患者肿瘤标志物及疾病预后的影响。方法:将福州市第二医院2018年1月—2022年6月收治66例前列腺癌患者按随机数字表法分为对照组(n=33)和观察组(n=33),对照组患者单纯进行三孔法经腹膜外腹腔镜下根治性前列腺切除术,观察组给予三孔法经腹膜外腹腔镜下根治性前列腺切除术联合间断抗雄激素。比较两组手术指标及术后1周血红蛋白下降量,治疗前及治疗后12个月前列腺特异性抗原(PSA)、前列腺酸性磷酸酶、肿瘤患者生活质量评分(QOL)评分、国际勃起功能指数(IIEF-5)评分,统计两组患者术后并发症及术后1年复发率。结果:观察组血红蛋白下降量为(22.68±5.18)g/L,明显低于对照组的(27.53±5.22)g/L;观察组术后尿管留置时间为(5.55±1.40)d,明显短于对照组的(8.60±1.66)d;观察组住院时间为(8.46±2.42)d,明显短于对照组的(10.30±2.10)d,差异均有统计学意义(P<0.05)。治疗后,观察组PSA、前列腺酸性磷酸酶分别为(2.51±0.74)ng/mL、(2.06±0.58)μg/L,均明显低于治疗前[(254.84±60.28)ng/mL、(23.66±6.42)μg/L]及对照组[(17.25±1.88)ng/mL、(9.35±1.86)μg/L],差异均有统计学意义(P<0.05)。治疗后,观察组QOL评分为(44.22±2.56)分,明显高于治疗前(40.12±6.58)分及对照组(42.57±3.76)分,差异均有统计学意义(P<0.05)。治疗后,观察组IIEF-5评分为(17.96±1.46)分,明显高于对照组的(14.96±1.10)分,差异有统计学意义(P<0.05)。观察组和对照组并发症发生率分别为3.03%和18.18%,差异有统计学意义(P<0.05)。观察组和对照组1年复发率分别为0和15.15%,差异有统计学意义(P<0.05)。结论:前列腺癌患者给予前列腺癌根治术联合间断抗雄激素治疗能够有效降低前列腺癌患者PSA水平,促进术后康复,降低并发症发生率,提高生活质量。

Objective:To investigate the effect of radical prostatectomy combined with intermittent antiandrogen on tumor markers and disease prognosis of prostate cancer.Method:A total of 66 patients with prostate cancer admitted to Fuzhou Second Hospital from January 2018 to June 2022 were divided into control group(n=33)and observation group(n=33)according to random number table method.Patients in the control group simply underwent radical prostatectomy by three-hole method via peritoneal laparoscopy.Observation group received radical prostatectomy by three-hole transperitoneal laparoscopy combined with intermittent antiandrogen.The operation indexes of both groups were compared,and the hemoglobin drop was calculated 1 week after operation,prostate-specific antigen(PSA),prostate acid phosphatase,tumor patient quality of life(QOL)score,and international index erectile function(IIEF-5)score before and 12 months after treatment were compared between the two groups,postoperative complications and 1-year postoperative recurrence rates were analyzed.Result:The decrease of hemoglobin in observation group was(22.68±5.18)g/L,which was significantly lower than(27.53±5.22)g/L in control group;the indentation time of urinary catheter in the observation group was(5.55±1.40)d,which was significantly shorter than(8.60±1.66)d in the control group;the length of hospitalization in the observation group was(8.46±2.42)d,which was significantly shorter than(10.30±2.10)d in the control group,the differences were statistically significant(P<0.05).After treatment,the PSA and prostate acid phosphatase in the observation group were(2.51±0.74)ng/mL and(2.06±0.58)μg/L respectively,which were significantly lower than[(254.84±60.28)ng/mL,(23.66±6.42)μg/L]before treatment and[(17.25±1.88)ng/mL,(9.35±1.86)μg/L]in the control group,the differences were statistically significant(P<0.05).After treatment,the score of QOL in the observation group was(44.22±2.56)points,which was significantly higher than(40.12±6.58)points before treatmentand and(42.57±3.76)points in the control group,the differences were statistically significant(P<0.05).After treatment,the score of IIEF-5 in the observation group was(17.96±1.46)points,significantly higher than(14.96±1.10)points in the control group,the difference was statistically significant(P<0.05).The complication rates of observation group and control group were 3.03%and 18.18%,the difference was statistically significant(P<0.05).The 1-year recurrence rates of observation group and control group were 0 and 15.15%,the difference was statistically significant(P<0.05).Conclusion:Radical prostatectomy combined with intermittent antiandrogen therapy can effectively reduce the level of PSA in patients with prostate cancer,promote postoperative rehabilitation,reduce the incidence of complications and improve the quality of life.