内分泌治疗后进展为去势抵抗性前列腺癌的危险或保护因素分析

陈炽炜; 林曼迪; 刘昊; 朱陆军; 曾海平; 王志刚; 王峻; 陈铭

doi:10.3971/j.issn.1000-8578.2020.19.1440

内分泌治疗后进展为去势抵抗性前列腺癌的危险或保护因素分析

Risk or Protective Factors of Prostate Cancer Progressing to Castration Resistant Prostate Cancer After Androgen Deprivation Therapy

摘要

摘要:
目的从前列腺癌的若干临床指标中，筛查早期（2年内）进展为去势抵抗性前列腺癌（CRPC）的可能危险及保护因素。

方法确诊前列腺癌后的2年内发生去势抵抗的患者作为病例组（n=71），2年内未发生去势抵抗的患者作对照组（n=71），应用Logistic回归模型及生存分析筛选出可能的危险或保护因素。

结果多因素Logistic分析：两组PSA最低值（PSA nadir）和到达最低值时间（TTN）差异具有统计学意义（均P < 0.05）。TTN≤9月和 > 9月时，发生CRPC中位时间是8.29和16月；PSA nadir≤0.2 ng/ml和 > 0.2 ng/ml时，发生CRPC中位时间是12和9月。

结论 TTN可能是早期进展为CRPC的保护因素，PSA nadir可能是早期进展为CRPC的独立危险因素，其中TTN≤9月和PSA nadir > 0.2 ng/ml是CRPC的危险因素。

Abstract:
Objective To screen the possible risk factors and protective factors for prostate cancer early (in 2 years)progressing to castration resistant prostate cancer (CRPC).
Methods A total of 71 patients who had progressed to CRPC in 2 years were classified as case group and 71 patients without progressing to CRPC in 2 years were classified as control group. Logistic regression analysis and survival analysis were applied to screen the risk or protective factors.
Results PSA nadir and Time to PSA nadir (TTN) were statistically significant between case group and control group in logistic regression analysis (P < 0.05). Median CRPC occurrence time was 8.29 and 16 months in TTN≤9 months group and TTN > 9 months group, respectively. Median CRPC occurrence time was 12 and 9 months in PSA nadir≤0.2 ng/ml group and PSA nadir > 0.2 ng/ml group, respectively.
Conclusion TTN may be a protective factor and PSA nadir may be an independent risk factor for prostate cancer early progressing to CRPC. TTN≤9 months and PSA nadir > 0.2 ng/ml are the risk factors of CRPC.

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