Correlation Between Prostate Cancer Risk Assessment And Gleason Grade、PSA After Radical Prostatectomy

IntroductionProstate cancer has became a main threat to health. With the further development of PSA detection and imaging,the early diagnosis of prostate cancer has been greatly improved,and the most effective way to a clinical organ-confined prostate cancer is radical prostatectomy.However,different prostate cancer risk assessments have different result for therapy. So prostate cancer risk assessment contribute to preoperative evaluation and prognosis of prostate cancer.Objection:With the increasing of prostate cancer incidence year by year in recent years,prostate cancer risk assessment is mainly used to guide therapy and prognosis.Retrospective analyzes the correlation between prostate cancer risk assessments and postoperative Gleason grade and postoperative PSA in one month through121prostate cancer patients,which have be underwent radical prostatectomy. Evaluate the application of prostate cancer risk assessment stratify in prostate cancer diagnosis and therapy. Methods:The research included121clinical organ-confined prostate cancer patients who were treated with radical prostatectomy between Jan2012and Dec2012.Patients postoperative follow-up in one month exclude lost of follow and clearly received adjuvant endocrine therapy in one month,remain63cases.Age42～79years, mean age66years, serum PSA0.989～141.215ng/ml, mean PSA13.004ng/ml,Gleason grade6～9, Gleason grade6is20cases, Gleason grade7is79cases. Gleason grade≥8is22cases.Clinical staging accords to patients’ prostate B ultrasound, prostate MRI, bone ECT and pathology,among them≤T2a47cases, T2b3cases,≥T2c71cases,lymph node metastasis7cases.This article retrospective analyzes prostate cancer patients underwent radical prostatectomy,can’t distinguish between the very low-risk and low-risk groups, so the very low risk group and the low-risk group were classified as low-risk.According to serum PSA, Gleason grade, clinical stage divided patients’ prostate cancer risk assessment into low, medium, high risk and very high-risk group. The low-risk group11cases, the medium-risk group37cases, the high-risk group43cases, the very high-risk group30cases.By reviewing postoperative PSA in one month, Gleason grade,analyze the correlation between prostate cancer risk assessments and postoperative Gleason grade and postoperative PSA in one month, and compare the difference of the proportion of postoperative PSA>0.2ng/ml in one month among kinds of prostate cancer risk assessments.All data are analyzed by software SPSS16.0for Windows,depending on the data select Chi-square test,Spearman rank correlation analysis, Fisher exact calculation of statistical methods, to analyze the data, define p<0.05as statistically significant.Result:The prostate cancer risk assessment comparing with Gleason grade(r=0.555,p <0.01),and postoperative PSA(r=0.507, p<0.01) in one month were both positive correlation,the proportion of postoperative PSA in one month>0.2ng/ml among low-risk, medium-risk, high-risk and very high-risk group was0,4.55%,36.36%,41.67%.The proportion of postoperative PSA in one month>0.2ng/ml among low-risk, medium-risk group were lower than high-risk and very high-risk group(p<0.05),there is no significant difference (p>0.1) between the low-risk group and risk group, also no significant difference (p>0.1) between the high-risk group and the very high-risk group.Conclusion:Prostate cancer risk assessment and postoperative PSA in one month and Gleason grade are positive correlation,the proportion of postoperative PSA in one month>0.2ng/ml among low-risk, medium-risk group was lower than high-risk and very high-risk group,there no significant difference between the low-risk group and risk group,also no significant difference between the high-risk group and the very high-risk group.