攝護腺健康指數與根除性攝護腺切除手術後腫瘤大小的關聯性
李宗叡、吳錫金、謝博帆、張兆祥、楊啟瑞、黃志平
中國醫藥大學附設醫院 泌尿部
The Relationship of Prostate Health Index to the Tumor Volume after Radical Prostatectomy
Tzung-Ruei Li, Hsi-Chin Wu, Po-Fan Hsieh, Chao-Hsiang Chang, Chi-Rei Yang,
Chi-Ping Huang
Department of Urology, China Medical University Hospital, Taichung, Taiwan
Purpose:
We aimed to analyze the predictive factors of prostate cancer and find its correlation to the volume of tumor after radical prostatectomy.
Materials and Methods:
We recruited 28 patients who received self-paid PHI examination and then underwent transrectal biopsy proved to be prostate cancer from March. 2018-Sep. 2019. Further MRI was or was not performed and radical prostatectomy all was performed. We analyzed the clinical data including PSA derivatives (PHI, p2PSA…), Prostate Cancer Prevention Trial(PCPT) calculator, Prostate Imaging-Reporting and Data System (PI-RADS), maximal cancer core lengths from biopsy, and evaluated the correlations to the pathological tumor size. All the statistical analysis was performed with SPSS 25.0.
Results:
The mean age was 64.89. After the radical prostatectomy, 19(67.9%) were pT2, and 9(32.1%) were pT3a. Pathological estimated tumor volume (cm3)(prostate volume×tumor percentage) showed 11.96± 8.06 in pT2 groups and 13.79±13.29 in pT3a group. Among all the clinical parameters, only PHI showed significantly different between these two groups(51.43±20.10, 87.74±47.29, p=0.008), whereas PSA (19.30± 28.77, 15.49±13.15, p=0.71) and p2PSA(30.38±24.44, 40.58±21.42, p=0.294), PIRAD score(3.78±1.06, 4.33±0.70, p=0.17), maximal core length(cm)(0.26±0.29, 0.19±0.22, p=0.569) were not. Further Pearson correlation revealed PHI had the best linear relationship to tumor size (ꭇ=0.663, p<0.001) than other possible predictors like p2PSA(ꭇ=0.391), age(ꭇ=0.249), PIRADS (ꭇ=0.239), PCPT(ꭇ=0.236),PSA(ꭇ=0.234) and tumor burden(ꭇ=0.08).
Conclusions:
Prostate Health Index outperforms other parameters and has strong correlation to tumor volume in Taiwanese population. Several studies had confirmed PHI correlates significantly with the pathological T stage. Therefore, PHI might be a good clinical factor and indicator for the treatment decision in advance.