术前血清睾酮预测前列腺癌根治术后局部转移和生化复发的研究报告

陆文宝; 张良; 刘小良; 黄鹏; 黄玉清; 余义

doi:10.13201/j.issn.1001-1420.2021.03.013

术前血清睾酮预测前列腺癌根治术后局部转移和生化复发的研究报告

- 1. 九江学院附属医院泌尿外科(江西九江, 332000);
- 2. 南昌大学第二附属医院泌尿外科
基金项目:
江西省卫生计生委科技计划(No:20185477)

详细信息

通讯作者: 余义,E-mail:474558310@qq.com

中图分类号: R737.25

收稿日期: 2020-06-06

Clinical study of preoperative serum testosterone in predicting local metastasis and biochemical recurrence of prostatic adenocarcinoma after radical surgery

- 1. Department of Urology, Affiliated Hospital of Jiujiang College, Jiujiang, Jiangxi, 332000, China;
- 2. Department of Urology, Second Affiliated Hospital of Nanchang University

More Information

Corresponding author: YU Yi, E-mail: 474558310@qq.com

Received Date: 06 June 2020

摘要

摘要: 目的:探讨术前血清总睾酮水平在接受前列腺癌根治术(RP)患者局部转移和术后生化复发之间的联系。方法:研究收集了2009年1月—2018年5月在九江学院附属医院及南昌大学第二附属医院接受RP患者108例,收集患者年龄、术前血清总睾酮、术前血清总前列腺特异性抗原(tPSA)、Gleason评分和病理分期等。局部转移前列腺癌定义为pT_3~4或N₁期,术后前列腺癌生化复发定义为连续2次测量tPSA＞0.2 ng/mL。研究调查临床和病理因素,如年龄、术前血清睾酮水平、tPSA和病理Gleason评分与局部转移和术后生化复发的关系。结果:局部转移前列腺癌患者的平均术前血清总睾酮显著低于非局部转移前列腺癌患者(407.66μg/dL vs.726.34μg/dL,P=0)。二分类Logistic回归分析显示,病理Gleason评分和术前血清总睾酮、血清tPSA是前列腺癌局部转移的重要预测因子。按血清睾酮25%百分数位置将患者分为高血清总睾酮和低血清总睾酮水平组,结果显示术前低血清总睾酮水平与术后复发有显著相关性(P=0.042)。结论:较低的术前血清总睾酮水平与局部转移前列腺癌分期和术后生化复发有密切相关。
- 血清睾酮 /
- 前列腺癌 /
- 病理分期 /
- 生化复发 /
- 临床分析
Abstract: Objective: To investigate the relationship between preoperative serum total testosterone levels and postoperative biochemical recurrence in patients undergoing radical resection of prostate cancer.Methods: A total of 108 patients who received RP in Affiliated Hospital of Jiujiang College and Second Affiliated Hospital of Nanchang University from January 2009 to May 2018 were studied and their age, preoperative serum total testosterone, preoperative serum tPSA, Gleason score and pathological stage were collected. Local metastatic prostate cancer was defined as stage pT₃—T₄ or N₁, and postoperative biochemical recurrence of prostate cancer was defined as two consecutive measurements of tPSA＞0.2 ng/mL. The study investigated the relationship between clinical and pathological factors, such as age, preoperative serum testosterone level, tPSA or pathological Gleason score, local metastasis and postoperative biochemical recurrence.Results: The average preoperative serum total testosterone of local metastatic prostate cancer patients was significantly lower than that of non-local metastatic prostate cancer patients(407.66 μg/dL vs. 726.34 μg/dL, P=0). Binary Logistic regression analysis showed that pathological Gleason score, preoperative serum total testosterone and serum tPSA were important predictors of local metastasis of prostate cancer. Patients were divided into high serum total testosterone group and low serum total testosterone group according to the 25% value of serum testosterone, and the results showed that there was significant correlation between low serum total testosterone level before surgery and postoperative recurrence(P=0.042).Conclusion: Low preoperative serum total testosterone level is closely related to local metastatic prostate cancer stage and postoperative biochemical recurrence.
- serum testosterone /
- prostate cancer /
- pathological stage /
- biochemical recurrence /
- clinical analysis

HTML全文

参考文献(23)

[1]	Weiner AB,Matulewicz RS,Eggener SE,et al.Increasing incidence of metastatic prostate cancer in the United States(2004-2013)[J].Prostate Cancer Prostatic Dis,2016,19(4):395-397.
[2]	Zhao Z,Kurimchak A,Nikonova AS,et al.PPP2R2A prostate cancer haploinsufficiency is associated with worse prognosis and a high vulnerability to B55α/PP2A reconstitution that triggers centrosome destabilization[J].Oncogenesis,2019,8(12):72.
[3]	林健海,阴雷,汪存洲,等.前列腺癌根治术后病理提示神经周围侵犯对预测生化复发的价值[J].临床泌尿外科杂志,2020,35(4):253-256,263.
[4]	周宇权,丁雪飞,徐嘉男,等.局限性前列腺癌患者治疗前血清睾酮水平与病理分级的研究[J].临床泌尿外科杂志,2019,34(9):673-678,682.
[5]	Ou R,Lv J,Zhang Q,et al.circAMOTL1 Motivates AMOTL1 Expression to Facilitate Cervical Cancer Growth[J].Mol Ther Nucleic Acids,2020,19:50-60.
[6]	Zhao Y,Ding L,Wang D,et al.EZH2 cooperates with gain-of-function p53 mutants to promote cancer growth and metastasis[J].EMBO J,2019,38(5):e99599.
[7]	Furuya Y,Nozaki T,Nagakawa O,et al.Low serum testosterone level predicts worse response to endocrine therapy in Japanese patients with metastatic prostate cancer[J].Endocr J,2002,49(1):85-90.
[8]	李雪贝,张良,饶太文,等.血清睾酮水平预测前列腺癌骨转移的临床研究[J].中华男科学杂志,2017,23(3):212-216.
[9]	Drobkova H,Jurecekova J,Grendar M,etal.Testos-teroneasaprospectivepredictorofpathological Gea-lsonscoreandpathologicalstageinprostatecancer[J].GenPhysiolBoiphys,2017,36(5):549-556.
[10]	Izzo L,Cardi A,Pugliese F,et al.Low-serum testosterone and high-chromogranin A rare case associated with high-grade prostate cancer and higher pathological stages of the disease[J].Ann Ital Chir,2019,90:451-456.
[11]	Albuquerque G,Guglielmetti GB,Barbosa J,et al.Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer[J].Rev Assoc Med Bras(1992),2017,63(8):704-710.
[12]	Jia ZW,Chang K,Dai B,et al.Factors influencing biochemical recurrence in patients who have received salvage radiotherapy after radical prostatectomy:a systematic review and meta-analysis[J].Asian J Androl,2017,19(4):493-499.
[13]	Morote J,Del Amo J,Borque A,et al.Improved prediction of biochemical recurrence after radical prostatectomy by genetic polymorphisms[J].J Urol,2010,184(2):506-511.
[14]	Liesenfeld L,Kron M,Gschwend JE,et al.Prognostic Factors for Biochemical Recurrence More than 10 Years after Radical Prostatectomy[J].J Urol,2017,197(1):143-148.
[15]	Heo JE,Lee JS,Goh HJ,et al.Urethral realignment with maximal urethral length and bladder neck preservation in robot-assisted radical prostatectomy:Urinary continence recovery[J].PLoS One,2020,15(1):e0227744.
[16]	Wong LM,Tang V,Peters J,et al.Feasibility for active surveillance in biopsy Gleason 3+4 prostate cancer:an Australian radical prostatectomy cohort[J].BJU Int,2016,117 Suppl 4:82-87.
[17]	Teloken PE,Li J,Woods CG,et al.The Impact of Prostate Cancer Zonal Origin on Pathological Parameters at Radical Prostatectomy and Subsequent Biochemical Failure[J].J Urol,2017,198(6):1316-1323.
[18]	Skove SL,Howard LE,Aronson WJ,et al.Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence[J].Urology,2017,108:129-134.
[19]	Artibani W,Porcaro AB,De Marco V,et al.Management of Biochemical Recurrence after Primary Curative Treatment for Prostate Cancer:A Review[J].Urol Int,2018,100(3):251-262.
[20]	Sokoll LJ,Zhang Z,Chan DW et al.Do Ultrasensitive Prostate Specific Antigen Measurements Have a Role in Predicting Long-Term Biochemical Recurrence-Free Survival in Men after Radical Prostatectomy?[J].J Urol,2016,195(2):330-336.
[21]	Nichols RC,Morris CG,Bryant C,et al.Serum Testosterone 60 Months after Passive-Scatter Proton Therapy for Localized Prostate Cancer[J].Cancer Invest,2019,37(2):85-89.
[22]	Lackner JE,Maerk I,Koller A,et al.Serum inhibin--not a cause of low testosterone levels in hypogonadal prostate cancer?[J].Urology,2008,72(5):1121-1124.
[23]	Borgato S,Persani L,Romoli R,et al.Serum FSH bioactivity and inhibin levels in patients with gonadotropin secreting and nonfunctioning pituitary adenomas[J].J Endocrinol Invest,1998,21(6):372-379.