经尿道前列腺切除术与前列腺癌根治术后生化复发的相关性

探讨经尿道前列腺切除术（TURP）与前列腺癌根治术（RP）治疗前列腺癌(PCa)患者术后生化复发（BCR）的相关性。方法 选取2013年1月至2017年12月就诊于本院的480例接受RP治疗的PCa患者。患者定期随访并完善前列腺特异性抗原（PSA）检测，术后连续2次检测PSA≥0.2 ng/mL定义为BCR，采用多因素Cox风险比例回归模型等方法探索TURP对RP术后BCR发生风险的影响。结果 480例RP患者中有400例患者未行过TURP治疗，80例患者既往行TURP治疗。行TURP治疗过的患者BCR发生时间显著缩短，与未行过TURP治疗的患者比较，差异有统计学意义（P=0.016）。有TURP手术史（HR=2.31,95%CI:1.33～4.04,P=0.003）、PSA升高（HR=1.01,95%CI:1.00～1.02,P=0.007）、T3b分期（HR=2.83,95%CI:1.16～6.87,P=0.022）、Gleason评分为7～9分（7分：HR=2.28,95%CI:1.09～4.75,P=0.028；8分：HR=2.90,95%CI: 1.24～6.80，P=0.014；9分：HR=5.55,95%CI:2.32～13.29,P<0.001）是BCR发生的独立危险因素。结论 在PCa患者中，TURP手术史、PSA升高、T3b分期及Gleason评分7～9分的患者在RP术后发生BCR的风险较高。

Relationship between transurethral resection of prostate and biochemical recurrence after radical prostatectomy

To investigate the relationship between transurethral prostatectomy (TURP) treatment patients and radical prostatectomy (RP) treatment of prostate cancer patients with biochemical recurrence (BCR).Methods  A total of 480 patients with prostate cancer who underwent radical prostate cancer treatment in our hospital from January 2013 to December 2017 were selected. Patients were followed up regularly and the prostate specific antigen (PSA) test was improved. PSA≥0.2 ng/mL was defined as BCR for 2 consecutive postoperative tests. Multivariate Cox risk ratio regression model was used to explore the effect of TURP on the risk of BCR.Results  Among the 480 patients undergoing radical prostatectomy, 400 patients had not been treated with TURP, and 80 patients had previously been treated with TURP. The incidence of BCR was significantly shortened in patients treated with TURP, and there was a statistical difference between the two (P=0.016). TURP (HR=2.31,95%CI:1.33～4.04,P=0.003), PSA increase (HR=1.01,95%CI:1.00～1.02,P=0.007), T3b staging (HR= 2.83, 95%CI:1.16～6.87,P=0.022), Gleason score 7～9 points (7 points:HR=2.28,95%CI:1.09～4.75,P=0.028; 8 points:HR=2.90,95%CI:1.24～6.80,P=0.014;9 points:HR=5.55, 95%CI:2.32～13.29,P<0.001) are independent risk factors for BCR.Conclusion  Among PCa patients, patients with a history of TURP surgery, elevated PSA, T3b stage, and Gleason score of 7～9 have a higher BCR risk after RP.