根治性前列腺切除术前游离睾酮值与肿瘤学结果和术后勃起功能有关。
Free testosterone value before radical prostatectomy is related to oncologic outcomes and post-operative erectile function.
机构信息
Department of Urology, the Fifth Affiliated Hospital of Guangzhou Medical University, 621 Gangwan RD, Huangpu district, Guangzhou, 510700, China.
Minimally Invasive Technique and Product Translational Center, Guangzhou Medical University, 621 Gangwan RD, Huangpu district, Guangzhou, 510700, China.
出版信息
BMC Cancer. 2019 Jan 18;19(1):87. doi: 10.1186/s12885-018-5148-1.
PURPOSE
To investigate whether free testosterone (FT) prior to radical prostatectomy was related to post-operative oncologic outcomes, erectile function and continence.
METHODS
The data of 586 patients with available information underwent treatment in our center was retrospectively reviewed. Total testosterone (TT) was tested by chemiluminescence immunoassay, and FT value was calculated using Vermeulen's formula. Post-operative continence and erectile function were evaluated by the requirement of pad and the IIEF-5 score at 12 months.
RESULTS
The median TT and FT value was 344 ng/dL (interquartile, IQR 314-374) and 6.9 ng/dL (IQR 6.4-7.3), and 106 patients (18.1%) and 152 patients (25.9%) were evaluated as having low TT and low FT based on current guidelines. Low TT and FT value were both related to older age (both p < 0.001), concomitant diabetes (p = 0.018 & 0.049), higher possibility of pre-operative erectile dysfunction (ED, both p < 0.001), higher pre-operative PSA value (both p < 0.001), higher clinical stage (both p < 0.001) and higher Gleason score in biopsy (both p < 0.001). Low FT was related to higher risk for pT3 (p = 0.020) and high Gleason score (p = 0.011) in logistic regression. The median follow-up duration was 52 moths (IQR 29-67) and FT was found to be an independent risk factor for biochemical recurrence (p = 0.005). In logistic regression TT was related to pre-operative ED (p = 0.010) and FT was related to post-operative ED (p = 0.001).
CONCLUSION
Low FT value before radical prostatectomy was related to adverse pathological outcomes, biochemical recurrence and post-operative ED.
目的
探讨根治性前列腺切除术前行游离睾酮（FT）检测与术后肿瘤学结局、勃起功能和控尿之间的关系。
方法
回顾性分析 586 例在我院接受治疗且有可用资料的患者。总睾酮（TT）采用化学发光免疫分析法检测，FT 值采用 Vermeulen 公式计算。术后 12 个月采用尿垫需求和 IIEF-5 评分评估控尿和勃起功能。
结果
中位 TT 和 FT 值分别为 344ng/dL（四分位间距，IQR 314-374）和 6.9ng/dL（IQR 6.4-7.3），106 例（18.1%）和 152 例（25.9%）患者依据当前指南被评估为低 TT 和低 FT。低 TT 和 FT 值均与年龄较大（均 p<0.001）、合并糖尿病（p=0.018 和 0.049）、术前勃起功能障碍（ED）可能性较高（均 p<0.001）、术前 PSA 值较高（均 p<0.001）、临床分期较高（均 p<0.001）和前列腺穿刺活检中 Gleason 评分较高（均 p<0.001）相关。多因素 logistic 回归分析显示，低 FT 与术后 pT3（p=0.020）和高 Gleason 评分（p=0.011）风险增加相关。中位随访时间为 52 个月（IQR 29-67），FT 是生化复发的独立危险因素（p=0.005）。多因素 logistic 回归分析显示 TT 与术前 ED 相关（p=0.010），FT 与术后 ED 相关（p=0.001）。
结论
根治性前列腺切除术前 FT 值较低与不良病理结局、生化复发和术后 ED 相关。
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