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目的研究前列腺癌的诊疗现状及影响前列腺癌患者预后的因素。方法将我院近10年收治的202名前列腺癌患者以规范开展PSA检查时间分为两组,1997-01～2001-12为第一组,2002-01～2007-07为第二组,对两组间年龄分布、病理分级和临床分期的分布进行比较。并对其中126例病理分级和临床分期完整且随访1年以上的患者进行生存分析。结果第一组收治前列腺癌患者35例,第二组收治前列腺癌患者167例,第二组是第一组的4.77倍;两组间年龄分布、病理分级构成比差别无统计学意义(P>0.05),两组间临床分期构成比差别有统计学意义(χ2=3.999,P<0.05),第二组早期患者明显增加。126例前列腺癌患者1年、3年、5年的总生存率分别为:88.24%,61.74%和22.8%;生存分析显示早期患者的生存率明显高于晚期患者(χ2=9.223,P<0.05),低分化患者的生存率明显比中分化和高分化低(χ2值分别为4.143,4.646,P<0.05),中分化和高分化患者生存率差别无统计学意义(χ2=0.172,P>0.05),发病年龄大于70岁的生存率较小于70岁高(χ2=6.533,P<0.05)。结论前列腺癌的发病趋势明显增加,规范的PSA检查有助于早期诊断前列腺癌。临床分期和病理分级是影响预后的主要因素。
Objective To study the status of diagnosis and treatment of prostate cancer and the factors affecting the prognosis of patients with prostate cancer. Methods Totally 202 prostate cancer patients treated in our hospital for 10 years were divided into two groups according to the criteria of PSA test. The first group was from January 1997 to December 2001, the second group was from January 2002 to July 2007, The age distribution, pathological grading and clinical stage distribution were compared between the two groups. 126 patients with pathological grading and clinical stage complete and follow-up of more than 1 year survival analysis. Results The first group of 35 patients with prostate cancer, the second group of 167 patients with prostate cancer, the second group is 4.77 times the first group; age distribution, pathological grade composition ratio was not statistically significant (P> 0.05). There was significant difference in clinical staging between two groups (χ2 = 3.999, P <0.05), and the second group was significantly increased in early stage. The overall survival rates of 126 prostate cancer patients at one year, three years and five years were 88.24%, 61.74% and 22.8% respectively. Survival analysis showed that the survival rate of patients with early stage prostate cancer was significantly higher than that of patients with advanced stage (χ2 = 9.223, P <0.05) ), The survival rate of poorly differentiated patients was significantly lower than that of moderately differentiated and well differentiated patients (χ2 = 4.143,4.646, P <0.05). There was no significant difference in survival between patients with well-differentiated and well-differentiated patients (χ2 = 0.172, P> 0.05). The survival rate of patients older than 70 years old was less than 70 years old (χ2 = 6.533, P <0.05). Conclusion The incidence of prostate cancer significantly increased the trend, the standard PSA test can help early diagnosis of prostate cancer. Clinical stage and pathological grade are the main factors affecting the prognosis.