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肝功能对根治性前列腺切除术后前列腺癌结局的影响。

The influence of hepatic function on prostate cancer outcomes after radical prostatectomy.

机构信息

Department of Surgery, Duke University Medical Center, Durham, NC, USA.

出版信息

Prostate Cancer Prostatic Dis. 2010 Jun;13(2):173-7. doi: 10.1038/pcan.2010.3. Epub 2010 Mar 2.

Abstract

Prostate growth is dependent on circulating androgens, which can be influenced by hepatic function. Liver disease has been suggested to influence prostate cancer (CaP) incidence. However, the effect of hepatic function on CaP outcomes has not been investigated. A total of 1181 patients who underwent radical prostatectomy (RP) between 1988 and 2008 at four Veterans Affairs hospitals that comprise the Shared Equal Access Regional Cancer Hospital database and had available liver function test (LFT) data were included in the study. Independent associations of LFTs with unfavorable pathological features and biochemical recurrence were determined using logistic and Cox regression analyses. Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) levels were elevated in 8.2 and 4.4% of patients, respectively. After controlling for CaP features, logistic regression revealed a significant association between SGOT levels and pathological Gleason sum > or =7(4+3) cancer (odds ratio=2.12; 95% confidence interval=1.11-4.05; P=0.02). Mild hepatic dysfunction was significantly associated with adverse CaP grade, but was not significantly associated with other adverse pathological features or biochemical recurrence in a cohort of men undergoing RP. The effect of moderate-to-severe liver disease on disease outcomes in CaP patients managed non-surgically remains to be investigated.

摘要

前列腺的生长依赖于循环雄激素,而雄激素的水平可受到肝功能的影响。有研究提示肝脏疾病可能会影响前列腺癌(CaP)的发病情况。然而,目前尚未有研究调查肝功能对 CaP 结局的影响。本研究共纳入了 1181 例于 1988 年至 2008 年在包含于 Shared Equal Access Regional Cancer Hospital 数据库的 4 家退伍军人事务部医院接受根治性前列腺切除术(RP)的患者,所有患者均有肝功能检查(LFT)数据。采用逻辑回归和 Cox 回归分析确定 LFT 与不良病理特征和生化复发的独立相关性。分别有 8.2%和 4.4%的患者出现血清谷氨酸草酰乙酸转氨酶(SGOT)和血清谷氨酸丙酮酸转氨酶(SGPT)水平升高。在控制了 CaP 特征后,逻辑回归显示 SGOT 水平与病理 Gleason 评分≥7(4+3)癌症显著相关(比值比=2.12;95%置信区间=1.11-4.05;P=0.02)。轻度肝功能障碍与不良 CaP 分级显著相关,但与接受 RP 的男性的其他不良病理特征或生化复发无显著相关性。中重度肝脏疾病对接受非手术治疗的 CaP 患者的疾病结局的影响仍有待研究。

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