精准医学杂志2024，Vol.39Issue(2)：144-147,4.DOI:10.13362/j.jpmed.202402010
前列腺癌腹腔镜下根治性切除术后切缘阳性的影响因素
Influencing factors for positive surgical margin after radical laparoscopic resection for prostate can-cer
摘要
Abstract
Objective To investigate the predictive factors for positive surgical margin after laparoscopic radical prosta-tectomy.Methods A retrospective analysis was performed for the clinical data of 238 patients with prostate cancer who received laparoscopic radical prostatectomy in Department of Urinary Surgery,The Affiliated Hospital of Qingdao University from June 2018 to May 2022,and they were divided into negative margin group and positive margin group according to postoperative patholo-gy.Related data of two groups were compared,including general clinical data(age,body mass index,prostate volume,and surgi-cal procedure),preoperative serum total prostate-specific antigen(TPSA),related indices[TPSA,free prostate-specific antigen/TPSA ratio,and prostate-specific antigen density(PSAD)],puncture-related factors(percentage of positive biopsy cores and pre-operative puncture Gleason score),and preoperative MRI radiological features(preoperative clinical stage,prostate imaging report and Prostate Imaging Reporting and Data System score,location of abnormal tumor signal on mpMRI,site of abnormal tumor sig-nal on mpMRI,membranous urethra length on mpMRI,and maximum transverse diameter of abnormal tumor signal on mpMRI),and the influencing factors for positive margin after laparoscopic radical prostatectomy were analyzed.Results There were sig-nificant differences between the two groups in serum TPSA,serum PSAD,preoperative puncture Gleason score,preoperative per-centage of positive biopsy cores,preoperative clinical stage,and location of abnormal signal on mpMRI(x2=22.539-62.367,P＜0.05).The multivariate analysis showed that preoperative clinical stage(OR=3.574,95％CI=1.975-9.298,P＜0.05)and preo-perative percentage of positive biopsy cores(OR=5.043,95％CI=2.496-10.189,P＜0.05)were independent influencing factors for positive margin.Conclusion Preoperative clinical stage and preoperative percentage of positive biopsy cores are independent influencing factors for positive margin after laparoscopic radical prostatectomy,and this study provides a reference for predicting positive margin based on mpMRI radiological features among clinicians.关键词
前列腺肿瘤/前列腺切除术/腹腔镜检查/磁共振成像/切缘阳性/影响因素Key words
Prostatic neoplasms/Prostatectomy/Laparoscopy/Magnetic resonance imaging/Positive margins of exci-sion/Influencing factor分类
医药卫生引用本文复制引用
贺大千,闫伟华,李杰,王昕凝,张铭鑫,杨学成..前列腺癌腹腔镜下根治性切除术后切缘阳性的影响因素[J].精准医学杂志,2024,39(2):144-147,4.基金项目
国家自然科学基金资助项目(82071750) （82071750）
