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[摘要]
目的 探讨影响去势抵抗性前列腺癌(CRPC)预后的因素。方法 收集2015年12月1日—2017年11月30日在天津中医药大学第一附属医院、天津医科大学肿瘤医院、天津医科大学总医院就诊符合纳入标准的CRPC患者。对18项纳入因素进行可靠性分析及效度分析;用Kaplan-Meier法进行单因素分析,筛选CRPC预后影响因素,绘制生存曲线;将单因素分析有意义的因素纳入COX比例风险模型,进行多因素分析,判断预后独立危险因素。结果 确诊CRPC时存在血尿症状、骨痛症状、血红蛋白(HGB)<120 g/L、胆固醇(CHO)>5.18 mmol/L、总前列腺特异性抗原(TPSA)>10 ng/mL、游离前列腺特异性抗原与总前列腺特异性抗原的比值(f/tPSA)>0.19、气血两虚证、未进行中药联合治疗为CRPC患者总生存时间(OS)的危险因素;CHO>5.18 mmol/L为CRPC患者OS的独立危险因素。CHO>5.18 mmol/L、HGB<120 g/L、气血两虚证为CRPC患者无进展生存时间(PFS)的危险因素,但不是CRPC患者PFS的独立危险因素。结论 CHO>5.18 mmol/L是CRPC患者OS的独立危险因素。
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[Abstract]
Objective To investigate the prognostic factors of castrated resistant prostate cancer (CRPC). Methods From December 1, 2015 to November 30, 2017, CRPC patients who met the inclusion criteria were collected from the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tumor Hospital of Tianjin Medical University, and General Hospital of Tianjin Medical University. The reliability and validity of 18 included factors were analyzed. The Kaplan-Meier method was used to screen the prognostic factors of CRPC and draw the survival curve.The significant fators from single factor analysis were included in COX proportional risk model for multiple-factor analysis to determine the independent prognostic factors. Results Hematuria, osteodynia, HGB < 120 g/L, CHO > 5.18 mmol/L, TPSA > 10 ng/mL, f/tPSA > 0.19, deficiency of both qi and blood, and no treatment of combination of traditional Chinese medicine were the risk factors for overall survival (OS) in CRPC patients; CHO > 5.18 mmol/L was the only risk factor for OS in CRPC patients, which was established as risk factors. CHO > 5.18 mmol/L, HGB < 120 g/L, and deficiency of both qi and blood were the risk factors for progression free survival (PFS) in CRPC patients, but they were not independent risk factors for PFS in CRPC patients. Conclusion CHO > 5.18 mmol/L is an independent risk factor for OS in CRPC patients.
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[基金项目]
天津市教委计划科研项目“健脾利湿化瘀方治疗前列腺癌在抑制微血管生成方面的作用与机制研究”(2018KJ037);天津市科技计划项目“天津市中医内科临床研究中心”(15ZXLCSY00020);天津市科技计划项目“中医药多靶位效应对难治性激素非依赖性前列腺癌临床治疗方案的研究”(12ZCDZSY17000);天津市卫生和计划生育委员会项目“益气解毒祛瘀方对激素非依赖性前列腺癌临床治疗方案的研究”(13081)