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在接受根治性前列腺切除术的局限性前列腺癌患者中,代谢综合征各组分的聚集与手术切缘阳性风险较高相关。

The accumulation of metabolic syndrome components is associated with higher risk of positive surgical margin among patients with localized prostate cancer after radical prostatectomy.

作者信息

Zheng Xiaonan, Qiu Shi, Liao Xinyang, Han Xin, Jin Kun, Yang Lu, Wei Qiang

机构信息

Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China,

Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

出版信息

Onco Targets Ther. 2019 Feb 26;12:1613-1620. doi: 10.2147/OTT.S195148. eCollection 2019.

Abstract

OBJECTIVE

To evaluate the association between metabolic syndrome (MetS) and the accumulation of its components with prostate cancer (PCa).

PATIENTS AND METHODS

Patients undergoing radical prostatectomy were retrospectively included. Patients were grouped by low risk and intermediate-high risk according to International Society of Urological Pathology grade. Multivariable logistic regression and Cox hazard regression model were utilized to assess the association of MetS with overall survival, biochemical recurrence, upgrading, upstaging, and positive surgical margin (PSM) after prostatectomy. Besides, trend test was also performed to evaluate the impact of the accumulation of MetS components on postoperative pathological feature.

RESULTS

A total of 1,083 patients were eventually enrolled. With a median follow-up of 40.45 months, 197 patients were diagnosed with MetS. No significant association between MetS and survival outcomes and pathological features was found. However, we did notice that the accumulation of the MetS components could lead to an elevated gradient of the PSM risk in the entire cohort (one component: OR=1.46; two components: OR=1.89; ≥3 components: OR=2.07; for trend=0.0194) and intermediate-high risk group (one component: OR=1.4; two components: OR=1.85; ≥3 components: OR=2.05; for trend=0.0127).

CONCLUSION

The accumulation of MetS components could lead to increasing risk of PSM on the entire PCa cohort and patients with intermediate-high risk PCa after prostatectomy, but not for the low-risk patients.

摘要

目的

评估代谢综合征(MetS)及其各组分的聚集与前列腺癌(PCa)之间的关联。

患者与方法

回顾性纳入接受根治性前列腺切除术的患者。根据国际泌尿病理学会分级将患者分为低风险组和中高风险组。采用多变量逻辑回归和Cox风险回归模型评估MetS与前列腺切除术后总生存、生化复发、病理升级、分期上升及手术切缘阳性(PSM)之间的关联。此外,还进行趋势检验以评估MetS各组分的聚集对术后病理特征的影响。

结果

最终纳入1083例患者。中位随访40.45个月,197例患者被诊断为MetS。未发现MetS与生存结局及病理特征之间存在显著关联。然而,我们确实注意到MetS各组分的聚集可导致整个队列(一个组分:OR = 1.46;两个组分:OR = 1.89;≥3个组分:OR = 2.07;趋势检验P = 0.0194)及中高风险组(一个组分:OR = 1.4;两个组分:OR = 1.85;≥3个组分:OR = 2.05;趋势检验P = 0.0127)中PSM风险梯度升高。

结论

MetS各组分的聚集可导致前列腺切除术后整个PCa队列及中高风险PCa患者PSM风险增加,但低风险患者不存在这种情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e512/6396662/31c7c7d3eb29/ott-12-1613Fig1.jpg

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