Porcaro Antonio Benito, Tafuri Alessandro, Sebben Marco, Cacciamani Giovanni, Ghimenton Claudio, Brunelli Matteo, Petrozziello Aldo, Monaco Carmelo, Migliorini Filippo, Siracusano Salvatore, Artibani Walter
Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy,
Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
Urol Int. 2019;103(4):391-399. doi: 10.1159/000496833. Epub 2019 Feb 14.
To evaluate the association between preoperative serum prolactin (PRL) levels and risk of non-organ confined prostate cancer (PCa) in clinically localized disease.
From December 2007 to December 2011, 124 patients with clinically localized PCa were retrospectively evaluated. Non-organ confined disease in the surgical specimen was defined according to extra-capsular extension, seminal vesicle invasion, positive surgical margins, and lymph node invasion. The association between clinical factors and serum levels of pituitary-testis hormones with the risk of non-organ confined disease was evaluated.
Perioperative factors associated with non-organ confined disease include prostatic-specific antigen (OR 1.144; p = 0.025), proportion of biopsy positive cores (BPC, OR 36.702; p = 0.007), bioptical Gleason Score > 6 (OR 2.785; p = 0.034), and PRL (OR 0.756, p < 0.0001). The association was strong for BPC (area under the curve [AUC] 0.704; p < 0.0001) and PRL (AUC 0.299; p < 0.0001). When we dichotomized according to median value, PRL ≤7.7 µg/L was an independent predictor of extraprostatic disease (OR 6.571; p < 0.0001) with fair discrimination power (AUC 0.704; p < 0.0001).
Low preoperative PRL levels predict the risk of non-organ confined PCa in clinically localized disease.
评估临床局限性疾病中术前血清催乳素（PRL）水平与非器官局限性前列腺癌（PCa）风险之间的关联。
回顾性评估2007年12月至2011年12月期间124例临床局限性PCa患者。手术标本中的非器官局限性疾病根据包膜外侵犯、精囊侵犯、手术切缘阳性和淋巴结侵犯来定义。评估临床因素和垂体-睾丸激素血清水平与非器官局限性疾病风险之间的关联。
与非器官局限性疾病相关的围手术期因素包括前列腺特异性抗原（OR 1.144；p = 0.025）、活检阳性核心比例（BPC，OR 36.702；p = 0.007）、活检Gleason评分>6（OR 2.785；p = 0.034）和PRL（OR 0.756，p < 0.0001）。BPC（曲线下面积[AUC] 0.704；p < 0.0001）和PRL（AUC 0.299；p < 0.0001）的关联很强。当我们根据中位数进行二分法时，PRL≤7.7μg/L是前列腺外疾病的独立预测因子（OR 6.571；p < 0.0001），具有良好的鉴别能力（AUC 0.704；p < 0.0001）。
术前PRL水平低可预测临床局限性疾病中非器官局限性PCa的风险。
