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在急性前列腺切除术后,前列腺特异性抗原持久性患者的发病率和瘤结果
Brian R Lane1,2, Patrick Lewicki3, Sabrina L Noyes1
1Division of Urology, Corewell Health West, Grand Rapids, Michigan, USA.
Cancer
|February 6, 2026
概括
患有前列腺切除术后抗原持久性 (PPP) 的患者有明显的不良结果. 这个高危人群需要单独的临床考虑和有针对性的治疗试验.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 前列腺癌研究 研究前列腺癌
背景情况:
- 目前的指导方针将根性前列腺切除术后的前列腺特异抗原持久性 (PPP) 与生化复发 (BCR) 归为一组,可能会掩盖独特的不良结果.
- 这种分组可能会掩盖RP后患有持续PSA的患者明显的和不利的预后.
研究的目的:
- 调查PPP患者是否代表独特的高风险人群,与没有疾病证据 (NED) 或BCR的患者分开.
- 量化NED,PPP和BCR组之间的RP前特征,RP后病理特征,治疗模式和死亡结果的差异.
主要方法:
- 在2013年1月至2024年6月期间,使用MUSIC注册表对15390名接受RP的前列腺癌患者进行了回顾性分析.
- 后RP状态的分类为NED,PPP (持续检测到的PSA) 和BCR (最初无法检测到的PSA,随后的上升≥0.2 ng/mL).
- 在定义的群体中比较RP前和RP后的特征,二次治疗策略和全因死亡率.
主要成果:
- 在15390名患者中,11019人患有NED,1919人患有PPP,2452人在4.0年的中位随访期内发展出BCR.
- 与NED和BCR组相比,PPP患者的RP前和RP后特征风险明显高.
- 与NED/BCR组合 (2.5%) 相比,PPP患者的5年全因死亡率明显高 (5.7%).
结论:
- 大约12.5% (8分之一) 的前列腺切除术患者患有PPP.
- 患有PPP的患者构成一个独特的高风险人群,与NED和BCR患者分开.
- 迫切需要进行临床试验,以确定这种高风险PPP人群的最佳治疗策略.
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