Ochiai Atsushi, Troncoso Patricia, Babaian R Joseph
Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
J Urol. 2007 Mar;177(3):903-6. doi: 10.1016/j.juro.2006.10.072.
We compared the relationships of serum prostate specific antigen to tumor volume and to noncancerous prostate tissue volume using multivariate analysis in men undergoing prostatectomy during 2 periods.
From our prostatectomy database we randomly selected 200 men from 1991 to 1994 (early group) and 200 from 2000 to 2003 (recent group) who underwent radical prostatectomy without neoadjuvant therapy. The variables analyzed were patient age, log prostate specific antigen, pathological stage, Gleason score, log total tumor volume and log noncancerous prostate tissue volume. Univariate correlation and multiple regression analyses were performed to assess the linearity of the relationships among the variables.
There was a significant difference between the early and recent groups in age (median 64 years, IQR 58-67 vs 59, IQR 53-65; p<0.001), prostate specific antigen (8.3 ng/ml, IQR 5.7-12.5 vs 5.8, IQR 4.4-7.8; p<0.001), total tumor volume (2.0 cc, IQR 1.0-3.6 vs 1.4, IQR 0.6-2.9; p<0.001), Gleason score (7, IQR 7-8 vs 7, IQR 7-7; p<0.001) and the incidence of extraprostatic disease (39% vs 18.5%, p<0.001) but not in noncancerous prostate tissue volume (35.7 cc, IQR 28.6-46.5 vs 37.1, IQR 28.9-50.1). There was a relationship between log prostate specific antigen and log total tumor volume (r=0.486, p<0.001 and r=0.237, p<0.01), and between log prostate specific antigen and log noncancerous prostate tissue volume (r=0.179, p<0.05 and r=0.138, p=0.051) in the early and the recent groups, respectively. Multiple regression analyses revealed that log total tumor volume, log noncancerous prostate tissue volume and Gleason score were significant independent variables for predicting log prostate specific antigen in the 2 groups. In the recent group log noncancerous prostate tissue volume had the most significant association with log prostate specific antigen (p<0.001), whereas in the early group log total tumor volume had the most significant association (p<0.001).
Although the relationship between serum prostate specific antigen and tumor volume decreased from early treatment years to recent years, the association remained at a significant level. In recent years noncancerous prostate tissue volume had the most significant association with prostate specific antigen.
我们在两个时期接受前列腺切除术的男性中，使用多变量分析比较了血清前列腺特异性抗原与肿瘤体积以及与非癌性前列腺组织体积之间的关系。
从我们的前列腺切除术数据库中，我们随机选择了1991年至1994年的200名男性（早期组）和2000年至2003年的200名男性（近期组），他们接受了根治性前列腺切除术且未接受新辅助治疗。分析的变量包括患者年龄、前列腺特异性抗原对数、病理分期、Gleason评分、肿瘤总体积对数和非癌性前列腺组织体积对数。进行单变量相关性和多元回归分析以评估变量之间关系的线性。
早期组和近期组在年龄（中位数64岁，四分位数间距58 - 67岁对59岁，四分位数间距53 - 65岁；p < 0.001）、前列腺特异性抗原（8.3 ng/ml，四分位数间距5.7 - 12.5对5.8，四分位数间距4.4 - 7.8；p < 0.001）、肿瘤总体积（2.0 cc，四分位数间距1.0 - 3.6对1.4，四分位数间距0.6 - 2.9；p < 0.001）、Gleason评分（7分，四分位数间距7 - 8对7分，四分位数间距7 - 7；p < 0.001）和前列腺外疾病发生率（39%对18.5%，p < 0.001）方面存在显著差异，但在非癌性前列腺组织体积方面无差异（35.7 cc，四分位数间距28.6 - 46.5对37.1，四分位数间距28.9 - 50.1）。在早期组和近期组中，前列腺特异性抗原对数与肿瘤总体积对数之间存在关系（r = 0.486，p < 0.001和r = 0.237，p < 0.01），以及前列腺特异性抗原对数与非癌性前列腺组织体积对数之间存在关系（分别为r = 0.179，p < 0.05和r = 0.138，p = 0.051）。多元回归分析显示，肿瘤总体积对数、非癌性前列腺组织体积对数和Gleason评分是两组中预测前列腺特异性抗原对数的显著独立变量。在近期组中，非癌性前列腺组织体积对数与前列腺特异性抗原对数的关联最为显著（p < 0.001），而在早期组中，肿瘤总体积对数的关联最为显著（p < 0.001）。
尽管从早期治疗年份到近年来血清前列腺特异性抗原与肿瘤体积之间的关系有所下降，但这种关联仍处于显著水平。近年来，非癌性前列腺组织体积与前列腺特异性抗原的关联最为显著。
