前列腺周围脂肪对前列腺癌术前分期和分级的影响

张强; 孙立江; 张桂铭; 齐隽; 杨志刚

doi:10.3971/j.issn.1000-8578.2018.17.1382

前列腺周围脂肪对前列腺癌术前分期和分级的影响

Influence of Periprostatic Adiposity Measurement Parameters on Preoperative Staging and Grading of Prostate Cancer

摘要

摘要:
目的分析前列腺周围脂肪对前列腺癌术前与术后分期、分级差异性的影响。
方法选取行前列腺癌根治性切除术的184例局限性前列腺癌患者为研究对象，采用MRI测量前列腺癌患者前列腺周围脂肪的相关指标，将前列腺周围脂肪测量指标与前列腺癌患者临床及病理学资料运用SPSS13.0进行统计学比较。
结果前列腺周围脂肪面积（PFA）及内脏脂肪比率（Ratio）在前列腺癌临床分期与病理分期差异组和非差异组之间差异有统计学意义（P=0.014, P=0.037）；并且二者与前列腺癌术前、术后分期差异之间有统计学意义（P=0.031, P=0.002）；而术前穿刺病理结果Gleason评分与根治术后Gleason评分差异组和非差异组之间，PFA脂肪测定指标方面差异有统计学意义（P=0.017）；并且前列腺周围脂肪测定指标PFA、前列腺移行区体积与前列腺癌术前、术后Gleason评分差异之间有统计学意义（P=0.018, P=0.028）。
结论前列腺周围脂肪对前列腺癌患者术前准确的临床分期、分级的评估有影响。

Abstract:
Objective To analyze the influence of periprostatic fat on the difference of staging/grading before and after radical retropubic prostatectomy(RRP).
Methods A total of 184 patients who underwent RRP were analyzed retrospectively. The different fat measurements were performed on the slices of MRI and compared with the clinical and pathologic factors using SPSS13.0.
Results The PFA and Ratio showed a significant difference between the difference group and the no difference one in clinical stage before operation and pathologic stage after operation (P=0.014, P=0.037). A statistical association was revealed between the PFA/Ratio and the difference of grading in pre-/post-RRP (P=0.031, P=0.002). In terms of Gleason score, nothing but "PFA" fat measurement was found to be different between two groups (P=0.017); Logistic regression analysis revealed a statistical association between the PFA/T-zone volume and the difference of grading in pre-/post-RRP (P=0.018, P=0.028).
Conclusion The periprostatic adipose has effect on accurate evaluation of preoperative staging and grading of PCa.

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