摘要
目的 验证Kattan列线图和Cancer of the Prostate Risk Assessment（CAPRA）评分对中国前列腺癌患者根治术后5年无生化复发生存率的预测能力.方法 筛选2001年1月至2008年2月295例行根治术的前列腺癌患者,剔除新辅助内分泌治疗、术后辅助内分泌治疗和术后辅助放疗患者后,共纳入211例患者.手术方式均为经腹膜外途径耻骨后根治性前列腺切除术.术后第2周拔除尿管前查血PSA,术后第6周查血PSA,此后每3个月复查PSA,1年后改为每6个月复查一次.生化复发标准为连续两次PSA＞0.2 μg/L.回顾性收集患者的PSA、Gleason评分、前列腺穿刺活检结果和手术年龄,计算Kattan和CAPRA评分预测的5年无生化复发率.并将本研究的患者资料与两项关于Kattan和CAPRA评分的临床研究资料进行比较.结果 本组患者5年总体无生化复发生存率为83.9％,Kattan列线图和CAPRA评分预测的5年无生化复发率分别为52.8％±25.6％和47.6％±26.9％.比较本研究的临床资料和建立Kattan列线图和CAPRA评分的源数据样本可以发现,本研究PSA≤10 μg/L患者所占的比例（30.3％）明显低于另两项研究（70.1％和81.6％）（P＜0.01）;本研究中低危Gleason评分（1～3/1～3）患者比例（44.1％）明显低于另两项研究（68.3％和74.2％）（P＜0.01）;在T分期方面,本研究资料与另两项研究比较差异无统计学意义（P＞0.05）.应用Kattan列线图和CAPRA评分预测本组患者5年无生化复发生存率的受试者工作特征曲线下面积分别为0.69（95％CI,0.60～0.78）和0.65（95％CI,0.56～ 0.73）.结论 中国人群前列腺癌的临床特征与建立Kattan列线图和CAPRA评分的人群特征具有明显差异.具有更高PSA水平和更高Gleason评分的中国人群,不适用于Kattan列线图和CAPRA评分进行前列腺癌根治术后生化复发的预测.
Objective To validate the accuracy of Kattan nomogram and Cancer of the Prostate Risk Assessment （CAPRA） scores in anticipating the 5 year recurrence free survival （RFS） after radical prostatectomy of Chinese patients.Methods Radical prostatectomy was performed in 295 patients from January 2001 to February 2008 in our hospital,and 211 of them were enrolled in this study after excluded the patients who had been performed neoadjuvant hormonal therapy,adjuvant hormonal therapy,or adjuvant radiotherapy.The surgeries were all performed by 3 experienced surgeons through retropubic approach.PSA was detected 2 weeks and 6 weeks after surgery,and then continuous monitoring of PSA every three months on the first year,and then every 6 months afterwards.The anticipated 5 year biochemical RFS was evaluated by Kattan nomogram and CAPRA scores which were calculated according to the PSA,Gleason scores,biopsy results and age.Finally,the data of the present study were compared with the original data of Kattan nomogram and CAPRA scores.Results The 5 year biochemical RFS was 83.9% in present study,however,the rate anticipated by Kattan nomogram and CAPRA scores was 52.8%±25.6% and 47.6%±26.9%.After compared the present study with other two studies,it seemed that the present PSA value was significantly higher than that in the original two studies ; and the present intermediate or low Gleason score rate was significantly lower than that of the original two studies （P〈0.01）.However,the three studies were comparable in clinical stage.The area under the receiver operator characteristic curve was 0.69 （95%CI,0.60-0.78） if we predicted the 5 year biochemical RFS rate with Kattan nomogram,and it would be 0.65 （95%CI,0.56-0.73） if with CAPRA scores.Conclusions The clinical characteristic of the present study is different from that of the other two studies with which other authors built the Kattan nomogram and CAPRA scores predicting system.And the differences,which are featured by higher PSA and Gleason scores,could b
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2015年第4期285-289,共5页
Chinese Journal of Urology
关键词
前列腺肿瘤
癌
生化复发
Kattan列线图
CAPRA评分
Prostatic neoplasms
Carcinoma
Biochemical recurrence
Kattan nomogram
Cancer of the Prostate Risk Assessment scores
