不同年龄组前列腺癌临床特征与预后因素分析

Clinical characteristics and prognostic factors for prostate cancer in different age groups

摘要:

目的：比较不同年龄组新发前列腺癌（prostate cancer，PCa）患者的临床特点及预后因素分析。方法：将我院从2006年1月至2013年5月间收治的新发PCa患者共105例分为低龄组（＜60岁）和高龄组（≥60岁），其中低龄组45例（中位年龄56岁）、高龄组60例（中位年龄72岁）。比较2组人群的首发症状、国际前列腺症状评分（international prostate symptom rating scale，IPSS）、总前列腺特异性抗原（total prostatespecific antigen，TPSA）、病理Gleason评分、临床分期、骨转移情况以及治疗方式。结果：2组患者却以尿频、排尿困难为首发症状占主导，只有骨痛症状在2组间有统计学意义（Z=-2.436，P=0.015）；低龄组患者中IPSS评分为轻、中、重症状的有11、23、11例，高龄组患者分别为8、15、37例，高龄组中患者症状较重（Z=-3.460，P=0.001）；低龄组和高龄组患者的TPSA中位值分别为97.77、47.32 ng/ml，有统计学意义（Z=-2.830，P=0.005）；低龄组和高龄组Gleason评分小于7分、等于7分、大于7分的患者分别为12、17、16例和30、19、11例，有统计学意义（Z=-2.580，P=0.01）；低龄组患者临床分期为Ⅰ~Ⅱ期有17例、Ⅲ~Ⅳ期有28例，高龄组患者临床分期为Ⅰ~Ⅱ期有32例、Ⅲ~Ⅳ期有28例，2组临床分期无统计学意义（Z=2.500，P=0.114）；低龄组和高龄组的骨转移分别为28例和22列，有统计学意义（ ?字2=4.618，P=0.032）；低龄组和高龄组行前列腺癌根治术的患者分别有15例、26例，余患者行内分泌治疗。结论：低龄组和高龄组患者多数以尿频、排尿困难为首发症状就诊，低龄组中以骨痛症状为首要表现的患者更多；低龄组患者较高龄组症状轻，但TPSA值更高、病理恶性程度高且更易发生骨转移，而２组间临床分期无明显差别。

Abstract:

Objective：To explore the different clinicopathological characteristics and prognostic factors for patients with prostate cancer （PCa） in different age groups. Methods：All 105 patients diagnosed with PCa from January 2006 to May 2013 were divided into young group（＜60 years，45 patients） and old group（≥60 years，60 patients）. Clinical symptoms，international prostate symptom rating scale （IPSS），total prostate specific antigen（TPSA），clinical staging，Gleason score，incidence of bone metastasis，and treatment in both groups were explored. Results：Frequent micturition and dysuria were the primary symptoms in both groups; there were significant differences in the symptom of ostalgia between the two groups（Z=-2.436，P=0.015）. There were significant differences in the IPSS score，TPSA value，and Gleason score between the two groups（Z=-3.460，P=0.001）（Z=-2.830，P=0.005）（Z=-2.580，P=0.01）. There was no sig－nificant difference in clinical staging（Z=2.500，P=0.114） but there were statistical differences in bone metastasis incidence between the two groups（?字2=4.618，P=0.032）. Fifteen and 26 patients respective in young group and old group received radical prostatectomy；the others underwent endocrine therapy. Conclusion：Frequent micturition and dysuria are the primary symptoms in both groups；but more patients in young group suffer from ostalgia symptom. The symptoms are lighter in young group；but TPSA value，pathological malignant degree and bone metastasis are more severe in young group. There is no difference in clinical staging between the two groups.