预测高危前列腺癌双侧淋巴结侵犯的临床因素
Clinical Factors Predicting Bilateral Lymph Node Invasion in High-Risk Prostate Cancer.
作者信息
Porcaro Antonio Benito, De Luyk Nicolò, Corsi Paolo, Sebben Marco, Tafuri Alessandro, Processali Tania, Mattevi Daniele, Pirozzi Marco, Cerruto Maria Angela, Amigoni Nelia, Rizzetto Riccardo, Brunelli Matteo A, Migliorini Filippo, Siracusano Salvatore, Artibani Walter
机构信息
Urologic Clinic, Ospedale Civile Maggiore, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
出版信息
Urol Int. 2017;99(4):392-399. doi: 10.1159/000476039. Epub 2017 May 10.
BACKGROUND
In high-risk prostate cancer (HR-PCA), it is important to consider the factors associated with extensive lymph node invasion (LNI) before planning treatment methods.
OBJECTIVE
To investigate clinical predictors of bilateral LNI in HR-PCA.
MATERIALS AND METHODS
The study evaluated 261 consecutive patients who underwent radical prostatectomy with extended pelvic lymph node dissection. The multivariate multinomial logistic regression model was computed.
RESULTS
The high-risk category included 102 cases. Overall, LNI was detected in 28 patients (27.5%) and was bilateral in 11 cases (10.8%). Independent factors associated with LNI were prostate-specific antigen (PSA) and proportion of positive cores. The main model showed that only higher values of PSA increased the odds of bilateral LNI when compared to patients having unilateral LNI (OR 1.058; p = 0.018). The area under the curve of PSA predicting bilateral LNI was 0.819.
CONCLUSIONS
In HR-PCA, the independent predictor of LNI was PSA, which varied among patients with bilateral and unilateral LNI.
背景
在高危前列腺癌（HR-PCA）中，在规划治疗方法之前考虑与广泛淋巴结侵犯（LNI）相关的因素很重要。
目的
研究HR-PCA中双侧LNI的临床预测因素。
材料与方法
本研究评估了261例连续接受根治性前列腺切除术并扩大盆腔淋巴结清扫术的患者。计算多变量多项逻辑回归模型。
结果
高危组包括102例。总体而言，28例患者（27.5%）检测到LNI，其中11例（10.8%）为双侧LNI。与LNI相关的独立因素是前列腺特异性抗原（PSA）和阳性核心比例。主要模型显示，与单侧LNI患者相比，仅较高的PSA值增加了双侧LNI的几率（OR 1.058；p = \0.018）。PSA预测双侧LNI的曲线下面积为0.819。
结论
在HR-PCA中，LNI的独立预测因素是PSA，其在双侧和单侧LNI患者中有所不同。
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