根治性前列腺切除术后Gleason评分升级相关因素分析

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[Abstract]ObjectiveThis studyaimed toanalyze theinfluencing factors ofGleason scoreupgrading（GSU）afterradical prostatectomy（R），soastoprovideabasisforaccurateclinicalassessmentofdiseasegrading.MethodsRrospectiveanalysiswas conductedon68prostatecancerpatientswhounderwentRPatJilinProvincialPeople'sHospitalbetweeJanuary2O19andJanuary 2025.BasedonwhetherthepostoperativeGleasonscore（GS）showedupgradingcompared withthebiopsyGS，thepatientsweredivided into an upgrading group （（ n=38 ） and a non-upgrading group （ n=30 ）.Variables showing statistically significant differences （ P<0.05 ）inunivariateanalysiswere subsequentlyincludedinamultivariatelogisticregresion model toidentifyfactors influencing post-RPGleasonscoreupgrading.ResultsTheGSUcohort exhibited significantlyelevated prostate-specificantigen（PSA）（ P< 0.05）and PSA density （ P<0.05 ），alongside reduced prostate volume（PV）（ P<0.05 ）and lower biopsy GS（ P<0.05 ）versus the non-GSU cohort.Elevated PSA（ OR=1 .129，95 %CI ：1.023-1.246， P=0.016 ），reducedPV（ OR=0.877 ， 95%CI ： 0. 877- 0. 979， P=0.007 ），and lower biopsy GS（ OR=0.426 ， 95%CI ： 0. 218-0.835， P=0.013 ）were independent risk factors for postoperative GSU.ConclusionPreoperative PSA，PV，and biopsy GS serve as critical predictors of GSU following RP ，enabling refined clinical decision-making for risk stratification.

[Key words] Prostate cancer；Radical prostatectomy；Gleason score upgrading；Prostate biopsy；Influencing factors

前列腺癌是全球范围内男性最常见的恶性肿瘤之一，在癌症相关死亡原因中占据重要地位[1-2]。（剩余9821字）