| 摘要: |
| 目的:通过将前列腺癌根治术后Gleason评分3+4和4+3患者进行对比，评价不同主要Gleason级别患者的临床特征差异。方法:回顾分析2001～2006年于我院行耻骨后前列腺根治性切除术的前列腺腺癌患者，37例术后病理诊断为Gleason 7分，根据主要级别不同分为3+4、4+3两组。定期随访判断患者有无生化复发或远处转移。应用放射免疫法检测血清前列腺特异性抗原（PSA）浓度，Kaplan-Meier法描述两组患者无进展生存曲线，COX回归模型分析影响疾病进展的独立相关因素。结果:两组患者前列腺包膜外侵犯率无统计学差异(21.1% vs 33.3%,P=0.462)；3+4组患者术后无进展生存时间长于4+3组(P=0.030)；COX回归模型显示Gleason级别是影响预后的独立相关因素（P=0.033），4+3组有着更高的生化复发风险。结论:不同分级的Gleason 7分前列腺癌的生物学行为不尽相同，根治术后3+4分和4+3分患者的预后明显不同，将Gleason 7分患者依照主要级别继续分型在临床上具有一定的可行性。 |
| 关键词: Gleason 7分 前列腺根治性切除术 疾病进展 生化复发 远处转移 |
| DOI：10.3724/SP.J.1008.2008.00904 |
| 投稿时间：2007-11-18修订日期：2008-07-02 |
| 基金项目: |
|
| Clinical characteristics of patients after radical prostatectomy for prostate cancer:a comparison between Gleason score 3+4 and Gleason score 4+3 |
| CAO Zhi-lie,SUN Ying-hao*,XU Chuan-liang,GAO Xu |
| (Department of Urological Surgery,Changhai Hospital,Second Military Medical University,Shanghai 200433,China) |
| Abstract: |
| Objective:To compare the clinical characteristics of patients with Gleason score 3+4 and Gleason score 4+3 after radical prostatectomy for prostate cancer.Methods: The clinical records of patients who underwent radical retropubic prostatectomy in our hospital from 2001 to 2006 were retrospectively analyzed.Thirty-seven patients with a Gleason score of 7 after operation were divided into 2 groups,Gleason score 3+4 group and Gleason score 4+3 group,according to major grading.The patients were followed up for biochemical recurrence and distant metastases.Radioimmunoassay was used to detect the serum prostate-specific antigen (PSA) level.Kaplan-Meier method was used to compare the progression-free survival curves and Cox regression model was used to analyze the independent factors influencing the disease progression.Results: The rates of extraprostatic extension at radical prostatectomy were not significantly different between 3+4 and 4+3 groups (21.1% vs 33.3%,P=0.462).The non-progression survival time of 3+4 group was markedly longer than that of 4+3 group (P=0.030).Cox regression model showed that Gleason primary grade was an independent factor of prognosis (P=0.033).4+ 3 group had a higher risk for biochemical recurrence.Conclusion: Prostate cancers of Gleason score 7 with different grades have different biologic behaviors.The prognoses of patients in 3+4 group and 4+3 group are different after operation.It is quite feasible to further classify the patients with Gleason 7 according to major grades. |
| Key words: Gleason score 7 radical prostatectomy disease progression biochemical recurrence distant metastases |
