Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Endocrinol (Lausanne). 2022 Oct 13;13:1020655. doi: 10.3389/fendo.2022.1020655. eCollection 2022.
To investigate the relationship between baseline clinicopathological and laboratory variables especially hematological parameters and lymphovascular invasion (LVI) in patients who underwent radical prostatectomy (RP).
We retrospectively evaluated 348 prostate cancer (PCa) patients who underwent RP in our center between May 2018 and June 2021. We divided them into non-LVI and LVI groups based on LVI status, and compared clinicopathological characteristics between non-LVI and LVI groups. Clinicopathological parameters including age, body mass index (BMI), history of hypertension and diabetes mellitus, neoadjuvant hormonal therapy (NHT), pathological stage T (pT) and lymph node status (pN), ISUP (international society of urological pathology) grade, positive surgical margin (PSM) rate, and hematological parameters containing prostate-specific antigen (PSA), whole blood parameters and inflammatory indexes were collected. The association between the clinicopathological parameters and the presence of LVI was identified by multivariate logistic regression analysis.
The pathological results of the RP specimen consisted of 53 (15.2%) patients with LVI and 295 (84.8%) cases without LVI. The level of PSA, percentages of advanced pT and grade, pN1, and PSM were significantly higher in the LVI group when compared with the non-LVI counterpart (p<0.001, p<0.001, p<0.001, p<0.001, p=0.007, respectively). Among the whole blood parameters, only red cell distribution width (RDW) was significantly different (41.2 ± 2.5 vs. 42.1 ± 3.1, p=0.035). Multivariate regression analysis demonstrated that RDW and NHT were negatively correlated with the presence of LVI (OR = 0.870, p=0.024; OR = 0.410, p=0.025), while PSA, ISUP, and pT were positively correlated with the presence of LVI (OR=1.013, p=0.005; OR =1.589, p=0.001; OR=1.655, p=0.008) after adjusting for confounding factors.
RDW rather than other whole blood parameters was independently and negatively associated with the presence of LVI in PCa patients, suggesting that RDW might play an essential role in PCa invasion.
研究接受根治性前列腺切除术（RP）的患者基线临床病理和实验室变量，尤其是血液学参数与淋巴管侵犯（LVI）之间的关系。
我们回顾性评估了 2018 年 5 月至 2021 年 6 月在我院接受 RP 的 348 例前列腺癌（PCa）患者。我们根据 LVI 状态将其分为无 LVI 组和 LVI 组，并比较两组间的临床病理特征。临床病理参数包括年龄、体重指数（BMI）、高血压和糖尿病病史、新辅助激素治疗（NHT）、病理分期 T（pT）和淋巴结状态（pN）、国际泌尿科病理学会（ISUP）分级、阳性切缘（PSM）率以及包括前列腺特异性抗原（PSA）、全血参数和炎症指标在内的血液学参数。采用多因素 logistic 回归分析确定临床病理参数与 LVI 存在的相关性。
RP 标本的病理结果包括 53 例（15.2%）有 LVI 和 295 例（84.8%）无 LVI。与无 LVI 组相比，LVI 组的 PSA 水平、高级别 pT 和分级、pN1 和 PSM 比例显著更高（p<0.001、p<0.001、p<0.001、p<0.001、p=0.007）。在全血参数中，只有红细胞分布宽度（RDW）有显著差异（41.2±2.5 比 42.1±3.1，p=0.035）。多因素回归分析表明，RDW 和 NHT 与 LVI 的存在呈负相关（OR=0.870，p=0.024；OR=0.410，p=0.025），而 PSA、ISUP 和 pT 与 LVI 的存在呈正相关（OR=1.013，p=0.005；OR=1.589，p=0.001；OR=1.655，p=0.008），校正混杂因素后。
RDW 而非其他全血参数与 PCa 患者的 LVI 独立且呈负相关，提示 RDW 可能在 PCa 浸润中发挥重要作用。
