高危局限性前列腺癌术前最大雄激素阻断治疗获益的临床预测

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【中图分类号】R697.03【文献标志码】A【收稿日期】2025-01-23

Clinical prediction of benefits from preoperative maximum androgen blocking therapy in high-risk localized prostate cancer

Huang Yongl，Zhou Fulin’，Li Jing²，Zhang Yaol （1.Department of Urology，The First Affiliated Hospital of Chongqing Medical University ; 2. The First Clinical College of Chongqing Medical University）

【AbstractObjective：Todevelopapredictive modelforselecting patients withhigh-risklocalizedprostatecancer（HRLPC）whoare suitable for preoperativemaximumandrogen blocking（MAB）therapyMethods：Thisstudywasconductedamong96patientswith HRLPC whowerediagnosedasedontransrectalbiopsyandunderwentradicalprostatectomyinDepartmentof Uology，TheFistAffiliated Hospital of Chongqing Medical University，from January 1 ， 2 0 2 1 to June 3O，2O24，and all patients received MAB therapy for 3 monthsbeforesurgeryandwerefolowedupfor6monthsaftersurgery.Relateddatawerecoectedfromallpatients，incudngbaseline demographicatues，boratorydtaagingfinseroeratiedatandfollupforatio.Atfisttoiatioen prostate-specificantigendensity（PSAD）stratificationafterMABtherapyandpathologicalandbiochemicalbenefits wasanalyzedto determine theoptimalPSADgroup，thenmachinelearning wasusedtoidentifyimportantvariablesandestablishapredictivemodel， andfinally，temodelwasevaluatedusingtheROCcure，thealibrationcurve，ndlinicalapliabilityassessment.Resultse low PSAD group [PSAD showed the best results of perioperative outcomes，pathological downgrading，the rate of undetectable PSA after-surgery，recovery from urinary incontinence，and PSA follow-up （ P <0.05）.The model was established based onprostatevo，wesityopoteinoleserol，D，igty，talosterol，，ddyssed predictive modelhadgoodperformance（withanareaundertheROCcurveofO.769）andshowedacertaindegreeofclinicalaplicability.Cnclusion：atientsintelowSADgrouptendtoavebeterpathologicalandbiochemicalbenefits.Thisstudyprovidesare liablepredictive model to assist in the individualized treatment of patientswith HRLPC.

【Keywords】high-risk localized prostate cancer;maximum androgen blocking therapy ; radical prostatectomy ; prostate-specific antigendensity;nomogram

前列腺癌（prostatecancer，PCa）是男性常见恶性肿瘤，近年来发病率和死亡率均呈上升趋势。（剩余10598字）