本文選題：前列腺根治術(shù) + 穿刺　； 參考：《福建醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的探討前列腺根治術(shù)后標(biāo)本較前列腺穿刺活檢標(biāo)本Gleason評分上升的影響因素。方法文章回顧性分析了2010年1月~2013年12月間我院164例接受前列腺穿刺活檢及根治性前列腺切除的前列腺癌患者年齡、術(shù)前血清PSA值、前列腺體積、PSAD、活檢標(biāo)本及根治術(shù)后標(biāo)本Gleason評分、穿刺至手術(shù)間隔時間、穿刺陽性針數(shù)、切緣陽性率、精囊侵犯、淋巴轉(zhuǎn)移等指標(biāo)。所有患者分為Gleason評分升高組和非升高組，運用Logistic單因素及多因素回歸分析等統(tǒng)計學(xué)方法比較分析引起根治術(shù)標(biāo)本Gleason評分上升的相關(guān)影響因素。結(jié)果164例患者中中95例（57.93%）活檢標(biāo)本和根治術(shù)后標(biāo)本Gleason評分一致，55例（33.54%）根治術(shù)后標(biāo)本Gleason評分上升，，14例（8.52%）根治術(shù)后標(biāo)本Gleason評分下降。單因素分析得出前列腺體積、PSAD、穿刺陽性針數(shù)、穿刺評分具統(tǒng)計學(xué)意義（P0.05），而其余年齡、術(shù)前PSA水平、臨床分期、切緣陽性率、精囊侵犯、淋巴轉(zhuǎn)移、穿刺至手術(shù)間隔時間則無顯著相關(guān)性（P0.05）。多因素Logistic回歸分析提示前列腺體積（P0.001）及穿刺評分（P=0.032）是影響根治術(shù)后標(biāo)本Gleason評分上升的獨立預(yù)測因子。結(jié)論前列腺體積越小及Gleason評分≤6的前列腺癌患者其術(shù)后標(biāo)本Gleason評分升高可能性越大。
[Abstract]:Objective to investigate the factors influencing the Gleason score of prostate biopsy specimens after radical prostatectomy. Methods from January 2010 to December 2013, 164 patients with prostate cancer underwent prostate biopsy and radical prostatectomy were analyzed retrospectively. The preoperative serum PSA values were analyzed retrospectively. Prostate volume, Gleason score of biopsy specimen and post-operation specimen, time between puncture and operation, number of positive needle puncture, positive rate of incision margin, invasion of seminal vesicle, lymphatic metastasis and so on. All the patients were divided into two groups: Gleason score increased group and non-elevated group. Univariate and multivariate regression analysis of Logistic were used to compare and analyze the related factors that caused the increase of Gleason score in radical operation specimens. Results the Gleason score of the biopsy specimens was the same as that of the specimens after radical operation in 95 of 164 patients (57.93). The Gleason score of the specimens increased in 14 patients after radical operation. The Gleason score of the specimens decreased after radical operation. Univariate analysis showed that the prostate volume, the number of positive needle puncture, the score of puncture were statistically significant (P 0.05), while the other age, preoperative PSA level, clinical stage, positive rate of incision margin, seminal vesicle invasion, lymphatic metastasis, There was no significant correlation between puncture and operation interval (P 0.05). Multivariate Logistic regression analysis showed that prostatic volume (P0.001) and puncture score (P0.032) were independent predictors of the increase of Gleason score after radical operation. Conclusion the smaller the prostate volume and the greater the Gleason score 鈮

本文編號：1877113