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学科主题: 泌尿外科学
题名:
前列腺体积对腹腔镜下前列腺根治性切除术后组织病理学预后的影响
其他题名: Effect of prostate volume on histopathological outcomes in patients after laparoscopic radical prostatectomy
作者: 张帆; 黄毅; 陆敏; 马潞林; 王国良
关键词: 前列腺肿瘤 ; 组织病理学 ; 前列腺切除术 ; 回顾性研究 ; Prostatic neoplasms ; Histopathological outcome ; Prostatectomy ; Retrospective studies
刊名: 中华泌尿外科杂志
发表日期: 2012
DOI: 10.3760/cma.j.issn.1000-6702.2012.05.010
卷: 33, 期:5, 页:360-363
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 探讨术前前列腺体积对于腹腔镜下前列腺根治性切除术后组织病理学预后的影响. 方法 回顾性分析2006年10月至2011年3月216例经前列腺穿刺括检诊断为前列腺腺癌并行腹腔镜下前列腺根治性切除术患者的资料,根据术前经直肠前列腺超声检查测定的前列腺体积将患者分为较小前列腺组( <30 ml)103例(47.7%)、中等前列腺组(30 ~60 ml)71例(32.9%)和较大前列腺组( >60ml)42例(19.4%).术前资料包括患者确诊时年龄、体质指数(BMI)、PSA、前列腺体积、穿刺阳性百分数、临床分期、穿刺Gleason评分等,术后组织病理学参数包括患者大体病理Gleason评分、是否存在术后病理升级、病理分期、切缘情况等.比较3组患者临床资料和术后组织病理学参数并进行统计学分析. 结果 3组患者术前PSA值随前列腺体积增大而升高,组间差异有统计学意义(P<0.01),年龄、BMI、穿刺Gleason评分、穿刺阳性百分数及临床分期等对比较差异均无统计学意义(P>0.05).小体积前列腺与较差的组织病理学预后相关,小体积前列腺痛患者术后Gleason评分较高(P =0.034),更容易出现大体病理升级现象(P=0.037),术后病理分期晚(P=0.025),特别是包膜侵犯的发生率增高(P =0.013).前列腺体积由小至大3组标本切缘阳性率分别为35.0%、33.8%和19.0%,差异无统计学意义(P =0.152). 结论 前列腺体积较小的前列腺癌患者行腹腔镜下前列腺根治性切除术后的组织病理学预后较差,肿瘤恶性程度高、病理分期晚,在临床工作中应予以重视. Objective To compare the clinical characteristic and postoperative histopathological parameters in different prostate size and to assess the effect of prostate volume on histopathological outcomes in patients after laparoscopic radical prostatectomy. Methods Two hundred and sixteen patients from 2006 to 2011 who were proved prostatic carcinoma by biopsy and performed laparoscopic radical prostatectomy wewe retrospectively evaluated.All patients were divided into the small group ( < 30 ml,103 cases),intermediate group(30 -60 ml,71 cases) and large group ( >60 ml,42 cases) according to prostate volume.Clinical variables included age,body mass index (BMI),preoperative PSA level,prostate volume,percentage of positive needles,clinical stage,and biopsy Gleason score (GS).Histopathological parameters included pathological GS,upgrading or not compared to biopsy GS,pathological stage and surgical margins status.Preoperative clinical variables and postoperative histopatholgogical parameters were compared among the 3 prostate groups. Results Patients with smaller prostates had lower PSA levels than those with intermediate and larger prostates (P =0.000).They also had worse histopathological outcomes such as pathological GS ( P =0.034 ),upgrading of GS ( P =0.037 ),and pathological stage ( P =0.025 ).35.0% of patients in smaller prostate group had a positive surgical margin compare to 33.8% and 19.0% in intermediate and larger prostate groups,but there was no significant difference (P =0.152). Conclusion Men with smaller prostate may have more high-grade cancer and more advanced disease after laparoscopic radical prostatectomy.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/72425
Appears in Collections:北京大学第三临床医学院_泌尿外科_期刊论文

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作者单位: 1.100191,北京大学第三医院泌尿外科
2.100191,北京大学基础医学院病理学系

Recommended Citation:
张帆,黄毅,陆敏,等. 前列腺体积对腹腔镜下前列腺根治性切除术后组织病理学预后的影响[J]. 中华泌尿外科杂志,2012,33(5):360-363.
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