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改良Gleason评分系统在7分转移性前列腺癌预后评估中的意义及与VEGF-C表达的关系
作者:张鸿毅1 2  赵刚刚1 2  李华锋1 2  肖克兵1 2  尹传民1 2  崔洁2 3 
单位:1. 西安医学院第一附属医院 泌尿外科, 陕西 西安 710077;
2. 西安医学院 全科医学院, 陕西 西安 710077;
3. 西安医学院第一附属医院 肿瘤科, 陕西 西安 710077
关键词:前列腺癌 改良Gleason评分系统 预后 血管内皮生长因子C 
分类号:R737.25
出版年·卷·期(页码):2019·38·第三期(451-455)
摘要:

目的:探讨改良Gleason评分系统在7分转移性前列腺癌预后评估中的意义及与VEGF-C表达的关系。方法:回顾性分析2005年1月至2011年8月收治的81例转移性前列腺癌患者的临床资料,Gleason评分均为7分,分为3+4分和4+3分两组;应用χ2检验分析临床因素与Gleason评分的关系,t检验进行计量资料的分析,Kaplan-Meier法和log-rank检验进行生存分析,COX回归模型分析生化复发和生存的不良预后因素。结果:Gleason评分3+4分和4+3分的患者区域淋巴结转移率分别为36.2%和63.8%(P=0.003),生化复发时间分别为24和18个月(P=0.014),生存期分别为40和28个月(P=0.012)。Gleason评分、前列腺体积、雄激素阻断治疗(ADT)后血清前列腺特异性抗原(PSA)水平与生化复发及生存有显著相关性。区域淋巴结转移是生化复发(P=0.001)和生存(P=0.003)的独立预后因素。与Gleason评分3+4分比较,4+3分前列腺癌组织血管内皮生长因子C(VEGF-C)表达显著增高。结论:改良Gleason评分系统可对7分的转移性前列腺癌预后作出准确评估;4+3分患者更易出现区域淋巴结转移,可能与VEGF-C高表达有关。

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