摘要
目的 通过对前列腺穿刺活检单针阳性并随之行前列腺根治手术患者的临床及病理参数进行分析,评估穿刺单针阳性前列腺癌的临床意义.方法 对45例接受12针前列腺穿刺活检中单针阳性确诊为前列腺癌并随后行前列腺癌根治术的患者的临床及病理资料进行分析,评价手术前后病理结果的非一致性,分析肿瘤术后病理分级及分期升高、神经周围侵犯、切缘阳性等肿瘤被低估的可能危险因素.结果 最终的根治病理显示,只有31.1％的患者为单侧前列腺癌.66.7％患者的术后分期升高;37.8％患者术后Gleason评分升高;31.1％患者术后切缘阳性.多因素Logistic回归分析显示,穿刺标本肿瘤组织百分率可能是肿瘤术后Gleason评分升高、术前临床分期低估及神经周围侵犯的危险因素.未发现患者的年龄、前列腺体积、术前血清前列腺特异性抗原（PSA）和PSA密度对肿瘤被低估有显著影响.结论 大部分前列腺穿刺单针阳性患者的肿瘤负荷被低估.穿刺标本肿瘤组织百分率可能是肿瘤被低估的危险因素.目前尚无法在术前准确预测局灶或单侧前列腺癌.
Objective To explore the clinicopathological implications of single positive core prostate cancer.Methods A total of 45 patients with transrectal ultrasound （TRUS）-guided prostate biopsy were diagnosed with single positive core prostate cancer and subsequently underwent radical prostatectomy （RP）.Their clinicopathological parameters were examined to identify the factors for disease upgrading or upstaging.Results On final pathology,only 31.1% patients had unilateral prostate cancer.And 37.8% patients experienced Gleason score upgrading,66.7% patients had upstaging and 31.1% were found positive surgical margins.On multivariable analyses,the percentage of positive cores was an independent predictor of stage upgrading and perineural invasion at RP pathology.Age,prostate volume and preoperative prostatespecific antigen/prostate-specific antigen density （PSA/PSAD） had no significant effect on underestimated tumor burden.Conclusions Most single positive core prostate cancer diagnosed by 12-core biopsy may be underestimated.The percentage of positive cores is an independent predictor of underestimated prostate cancer.Currently we have no instruments for accurately identifying microfocal or unilateral prostate cancer.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第20期1602-1605,共4页
National Medical Journal of China
基金
江苏省六大人才高峰（WSN-005）
南京市卫生局杰出青年基金（JQX12004）
