不同LHRH激动剂治疗转移性激素敏感性前列腺癌中PSA和睾酮水平的差异对照研究

麦伍拉尼·马木提; 阿孜古力·克热木; 艾克拜尔·吾曼尔; 阿里木江·吾布力卡斯木

doi:10.13201/j.issn.1001-1420.2021.12.012

不同LHRH激动剂治疗转移性激素敏感性前列腺癌中PSA和睾酮水平的差异对照研究

- 1. 新疆维吾尔自治区人民医院泌尿中心(乌鲁木齐, 830001);
- 2. 新疆维吾尔自治区人民医院临床检验中心

详细信息

通讯作者: 艾克拜尔·吾曼尔,E-mail:akberomer@126.com

中图分类号: R737.25

收稿日期: 2021-05-09

Comparison of PSA and testosterone levels in patients with metastatic hormone-sensitive prostate cancer treated with different LHRH agonists

- 1. Department of Urology Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830001, China;
- 2. Department of Clinical Laboratory Center, People's Hospital of Xinjiang Uygur Autonomous Region

More Information

Corresponding author: Aikebaier·Wumaner, E-mail: akberomer@126.com

Received Date: 09 May 2021

摘要

摘要: 目的：探讨不同黄体生成激素释放激素（LHRH）激动剂治疗转移性激素敏感性前列腺癌（metastatic hormone-sensitiveprostatecancer，mHSPC）中前列腺特异性抗原（PSA）和睾酮水平的差异。方法：回顾性分析新疆维吾尔自治区人民医院2017年1月—2020年1月收治的335例转移性激素敏感性前列腺癌患者的临床资料。均行雄激素剥夺（ADT）+辅助治疗（抗雄激素治疗，抗骨质破坏等），其中83例接受醋酸亮丙瑞林治疗（亮丙瑞林组）、154例接受醋酸戈舍瑞林治疗（戈舍瑞林组）、98例接受醋酸曲普瑞林治疗（曲普瑞林组）。对患者临床资料（发病年龄、远处转移分期、风险分层、肿瘤负荷、病理分级等）以及治疗后1年内PSA （治疗前、治疗后PSA 50%降幅率、90%降幅率、降到4 ng/mL、降到0.2 ng/mL的各组百分比）和睾酮水平（治疗前、治疗后睾酮降低水平以及不同组1个月内达到去势水平百分比的差异）进行对照分析。结果：本研究纳入了335例mHSPC患者都完成随访12月，研究中不同治疗组患者年龄、远处转移分期、风险分层、肿瘤负荷、前列腺病理分级等基线水平差异无统计学意义（P>0.05），患者基线特征具有可比性。不同治疗组之间，治疗后1、3、6、9、12个月的PSA平均水平比较差异均有统计学意义（P<0.05）。不同治疗组1个月PSA平均水平降到P_90%（90%的降幅率）、4 ng/mL，6个月PSA平均水平降到0.2 ng/mL的比例差异有统计学意义（P<0.05）。治疗后6、9、12个月的睾酮平均水平比较差异均有统计学意义（P<0.05），其余PSA、睾酮水平比较差异均无统计学意义（P>0.05）。结论：不同LHRH激动剂治疗mHSPC中1年内PSA和睾酮水平变化有差异，曲普瑞林降低PSA水平的疗效优于戈舍瑞林，戈舍瑞林和曲普瑞林降低睾酮水平的疗效优于亮丙瑞林（6~12个月）。1月内曲普瑞林组睾酮水平达到趋势水平的比例略高于其他2组。
- 前列腺肿瘤 /
- 黄体生成激素释放激素 /
- 前列腺特异性抗原 /
- 睾酮
Abstract: Objective: To investigate the difference of PSA and testosterone levels in metastatic hormone-sensitive prostate cancer(mHSPC) treated with different LHRH agonists.Methods: Clinical data of 335 patients with mHSPC admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2017 to January 2020 were retrospectively analyzed. All patients were treated with ADT(androgen deprivation) + adjuvant therapy(anti-male, anti-bone destruction, etc.), among which 83 patients were treated with leuprorelin acetate(group 1), 154 patients were treated with goserelin acetate(group 2), and 98 patients were treated with triprelin acetate(group 3). Clinical data(age of onset, stage of distant metastasis, risk stratification, tumor burden, pathological grade, etc.), PSA(50% reduction rate of PSA, 90% reduction rate of PSA before and after treatment, the percentage of PSA decreased to 4 ng/mL, 0.2 ng/mL in each group) and testosterone level(the decrease of testosterone level before and after treatment, and the difference of percentage of castration level reached within 1 month in different groups) were comparatively analyzed.Results: In this study, 335 mHSPC patients were included and followed up for 12 months. There was no statistically significant difference in baseline levels of age, distant metastasis stage, risk stratification, tumor burden, or prostate pathology grade among patients in different treatment groups(P>0.05), and the baseline characteristics of the patients were comparable. There was statistically significant difference in the mean PSA levels of 1, 3, 6, 9 and 12 months after treatment among different treatment groups(P<0.05). There was statistical significance in the proportion of the average PSA level to P90%(90% reduction rate), 4 ng/ml one month after treatment and 0.2 ng/ml six months after treatment among different treatment groups(P<0.05). There was statistically significant difference in the average level of testosterone in 6 months, 9 months and 12 months after treatment(P<0.05), while there was no statistically significant difference in the other PSA or testosterone levels(P>0.05).Conclusion: In the treatment of mHSPC with different LHRH agonists, the changes of PSA and testosterone levels within 1 year were different. Triprelin showed better efficacy in reducing PSA levels than goserelin did, and goserelin and triprelin showed better efficacy in reducing testosterone levels than leuprorelin did(from 6 months to 12 months). The percentage of the triprelin group that had reached trend testosterone levels in 1 month was slightly higher than that of the other two groups.
- prostate cancer /
- luteinizing hormone releasing hormone /
- prostate-specific antigen /
- testosterone

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