天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (12): 1180-1184.doi: 10.11958/20201663

• 临床研究 • 上一篇    下一篇

术前控制营养状态评分对寡转移性前列腺癌患者术后PSA进展的预测价值

王为1，华立新2，丁亮1△，李鹏超2   

  1. 1江苏省人民医院浦口分院泌尿外科（邮编211800）；2江苏省人民医院泌外科
  • 收稿日期:2020-06-13 修回日期:2020-09-11 出版日期:2020-12-15 发布日期:2020-12-13
  • 通讯作者: 丁亮 E-mail:dingliang008@21cn.com
  • 作者简介:王为（1973），男，本科，副主任医师，主要从事泌尿系统肿瘤的临床与基础方面研究
  • 基金资助:
    江苏省六大人才高峰项目（2016-WSW-033）

The predictive value of preoperative nutritional status score for postoperative PSA #br# progression in patients with oligometastatic prostate cancer#br#

WANG Wei1, HUA Li-xin2, DING Liang1△, LI Peng-chao2   

  1. 1 Department of Urology, Pukou Branch of Jiangsu Provincial People’s Hospital, Nanjing 211800, China; 
    2 Department of Urology, Jiangsu Provincial People’s Hospital
  • Received:2020-06-13 Revised:2020-09-11 Published:2020-12-15 Online:2020-12-13
  • Contact: ING Liang E-mail:dingliang008@21cn.com

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摘要： 目的　探讨术前控制营养状态（CONUT）评分评估寡转移性前列腺癌（OPC）患者术后前列腺特异性抗原（PSA）进展的临床价值。方法　选取2016年1月1日—2018年12月31日在我院行腹腔镜下前列腺癌根治术治疗的OPC患者102例，测定患者术前3 d内血清白蛋白水平、外周血淋巴细胞总数和总胆固醇水平并计算CONUT评分。收集PSA水平、T分期、N分期、切缘阳性、新辅助雄激素剥夺治疗（ADT）等资料，计算体质量指数（BMI）。绘制受试者工作特征（ROC）曲线确定CONUT预测PSA进展的界值，分析不同CONUT评分患者临床特征的差异。Cox回归分析患者PSA进展的影响因素，Kaplan-Meier法绘制生存曲线分析CONUT评分与患者PSA进展的关系。计算所有患者PSA无进展生存期（PSA-PFS）。结果　截止2019年12月31日，102例患者中PSA进展62例。CONUT评分预测OPC患者PSA进展的界值为3分，低CONUT组（＜3分，50例）和高CONUT组（≥3分，52例）患者在Gleason评分、T分期、切缘阳性方面差异均有统计学意义（P＜0.01）。Cox回归分析显示，CONUT评分≥3分是OPC患者预后的独立危险因素（HR=2.982，95%CI：1.706～5.213，P＜0.01），生存分析结果显示，高CONUT组患者PSA-PFS明显短于低CONUT组（P＜0.01）。结论　CONUT评分可成为OPC患者PSA进展的有效预测指标，≥3分提示PSA进展风险。

关键词: 前列腺肿瘤, 前列腺特异抗原, 寡转移, 控制营养状态评分

Abstract: Objective　To investigate the clinical value of preoperative controlling nutritional status (CONUT) score in postoperative prostate specific antigen (PSA) progression in patients with oligometastatic prostate cancer (OPC). Methods　From January 1, 2016 to December 31, 2018, 102 patients with OPC who underwent laparoscopic radical prostatectomy in our hospital were included. Serum albumin concentration, peripheral blood lymphocyte count and total cholesterol concentration were measured 3 days before operation, and CONUT score was calculated. The data of body mass index (BMI), PSA level, T stage, N stage, positive margin and ADT were collected. Receiver operating characteristic (ROC) curve was drawn to determine the cut-off value of CONUT in predicting PSA progression. The differences of clinical characteristics in patients with different CONUT scores were analyzed. Cox regression was used to analyze the factors influencing PSA progression. Kaplan-Meier method was used to draw survival curve and analyze the relationship between CONUT score and PSA progress. Prostate specific antigen progression-free survival (PSA-PFS) was calculated. Results　 Until December 31, 2019, 62 of 102 patients showed PSA progression. The cut-off value of CONUT score in predicting the progression of PSA in OPC patients was 3 points. There were significant differences in Gleason score, T stage and positive margin between low CONUT group (＜ 3 points, 50 cases) and high CONUT group (≥ 3 points, 52 cases, all P＜0.01). Cox regression analysis showed that CONUT score ≥ 3 was an independent risk factor for the prognosis of patients with OPC (HR = 2.982, 95%CI: 1.706-5.213, P＜0.01). The survival analysis showed that PSA-PFS was significantly shorter in high CONUT group than that in low CONUT group (P＜0.01). Conclusion　CONUT score can be an effective predictor for PSA progression in patients with OPC, and ≥ 3 points indicate the risk of PSA progression.

Key words: prostatic neoplasms, prostate-specific antigen, oligometastasis, controlling nutritional status score

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