摘要
目的:探究二次前列腺穿刺活检在转移性去势抵抗前列腺癌(CRPC)中的临床应用意义。方法:随机选取2014年7月至2017年7月本院收治的CRPC患者63例为研究对象。患者均行二次前列腺穿刺活检。根据二次穿刺结果将患者分为合并前列腺导管内癌(IDC-P)组(43例)、未合并IDC-P组(20例),比较两组及首次穿刺与二次穿刺时的前列腺特异抗原(PSA)和相关参数水平,并观察患者随访、治疗预后情况。结果:首次穿刺结果显示,13例合并IDC-P,50例单纯普通腺癌;二次穿刺结果显示分别43例、20例。首次穿刺时患者PSA、PSAD、PSATZ分别(14.28±2.39) ng/m L、(0.26±0.41) ng/m L、(0.65±0.86) ng/m L,二次穿刺时分别(17.32±2.73) ng/m L、(0.43±0.49) ng/m L、(0.99±1.01)ng/m L,比较差异有统计学意义(t=70.968、16.867、17.991,P <0.05)。合并IDC-P组PSA、PSAD、PSATZ水平分别(19.39±3.18) ng/m L、(0.57±0.52) ng/m L、(1.27±1.03) ng/m L,高于未合并IDC-P组(15.26±2.59) ng/m L、(0.30±0. 39) ng/m L、(0. 71±0. 81) ng/m L,差异有统计学意义(t=5. 072、2. 064、2. 140,P <0.05)。平均随访(23.65±4.52)个月,死亡者11例,52例(合并IDC-P者34例)在确诊为CRPC后进行化疗,合并IDC-P患者中有治疗反应者7例(20.59%),未合并IDC-P患者中有治疗反应者12例(66.67%),两组比较差异有统计学意义(χ~2=10.777,P <0.05)。结论:二次穿刺活检有利于临床及时了解转移性前列腺癌成分(IDC-P)改变,对CRPC的治疗及预后具有重要指导价值。
Objective:To explore the clinical significance of secondary prostate biopsy in metastatic castration-resistant prostate cancer(CRPC).Methods:63 patients with CRPC in our hospital from July 2014 to July 2017 were randomly selected as the research subjects.All patients underwent secondary prostate biopsy.According to the secondary puncture results,the patients were divided into the combined intra-canal carcinoma(IDC-P)group(43 cases)and the unconsolidated IDC-P group(20 cases).The levels of prostate-specific antigen(PSA)and related parameters at the time of first puncture and second puncture were compared between the two groups.The follow up and prognosis of the patients were observed.Results:The first puncture results showed that 13 cases had IDC-P and 50 cases had normal adenocarcinoma.The second puncture results showed 43 cases had IDC-P and 20 cases had normal adenocarcinoma.The PSA,PSAD and PSATZ were(14.28(+2.39)ng/mL,(0.26(+0.41)ng/mL and(0.65(+0.86)ng/mL respectively at the first puncture.At the second puncture,they were(17.32±2.73)ng/mL,(0.43±0.49)ng/mL,(0.99±1.01)ng/mL,respectively.The difference was statistically significant(t=70.968,16.867,17.991,P<0.05).The levels of PSA,PSAD,and PSATZ in the combined IDC-P group were(19.39±3.18)ng/mL,(0.57±0.52)ng/mL,and(1.27±1.03)ng/mL,respectively.Higher than the uncombined IDC-P group(15.26±2.59)ng/mL,(0.30±0.39)ng/mL,(0.71±0.81)ng/mL.The difference was statistically significant(t=5.072,2.064,2.140,P<0.05).At the mean follow-up(23.65±4.52)months,11 patients died,and 52 patients(34 patients with IDC-P combined)received chemotherapy after the diagnosis of CRPC.There were 7 patients(20.59%)who had treatment responders in patients with IDC-P and 12 patients(66.67%)who had not responded to IDC-P.The difference between the two groups was statistically significant(χ2=10.777,P<0.05).Conclusion:The second biopsy is beneficial to the clinical understanding of the changes of metastatic prostate cancer(IDC-P)in a timely manner and has important guiding value for the
作者
王帅
高凡
林涛
WANG Shuai;GAO Fan;LIN Tao(Jinzhou Central Hospital,Liaoning Jinzhou 121001,China)
出处
《河北医学》
CAS
2018年第12期2037-2040,共4页
Hebei Medicine
基金
辽宁省自然科学基金项目
(编号:201402004)
关键词
穿刺活检
前列腺癌
前列腺导管内癌
前列腺特异抗原
Needle biopsy
Prostatic carcinoma
Intraductal carcinoma of the prostate
Prostate-specific antigen
