腹腔镜盆腔淋巴结活检术在前列腺癌分期中的意义

Significance of laparoscopic pelvic lymph node sampling in the staging of prostate cancer

目的 评价腹腔镜盆腔淋巴结活检术在前列腺癌分期中的作用。 方法 对 36例临床分期T1b～T3a前列腺癌患者行腹腔镜盆腔淋巴结活检术 ,患者全身骨扫描均未见骨转移 ,盆腔CT或MRI未发现转移灶。血PSA 2 .7～ 2 30 .0ng/ml,平均 16 .0ng/ml。Gleason评分 5～ 10分 ,平均 6 .5分。 结果 36例患者中 ,盆腔淋巴结活检阳性 6例 (16 .7% )。临床分期、PSA及Gleason评分与盆腔淋巴结活检的阳性率密切相关。手术时间 30～ 14 2min ,平均 82min。术后住院时间 1～ 10d ,平均 2d。并发症发生率 8.3% (3/36 )。 结论 腹腔镜盆腔淋巴结活检术安全、有效 ,对判断前列腺癌患者有无盆腔淋巴结转移、前列腺癌分期有重要意义。

Objective To assess the role of laparoscopic pelvic lymph node sampling(LPLNS) in the staging of prostate cancer. Methods Thirty-six patients with T_ 1b ～T_ 3a prostate cancer had laparoscopic pelvic lymph node sampling.Both the bone scan and CT or MRI of all patients were negative.Prostate specific antigen(PSA) ranged from 2.7 to 230.0 ng/ml(mean,16.0 ng/ml).Gleason score ranged from 5 to 10(mean 6.5). Results Of the 36 patients,6(16.7%) had a positive dissection.Clinical staging,PSA and Gleason score were all significantly relevant with positive node finding.The operative duration was 30 to 142 min (mean,82 min).The postoperative hospital stay was 1 to 10 days(mean,2 days).The operative complication rate was 8.3%(3/36). Conclusions Laparoscopic pelvic lymph node sampling is a safe and effective method to detect positive pelvic lymph nodes in patients with prostate cancer.