【摘要】 目的 分析影响术后切缘阳性的危险因素，并探讨切缘阳性组中发生前列腺特异性抗原(PSA)进展的高危因素。方法 回顾性分析2018年8月-2021年8月在山西医科大学第一医院行根治性前列腺切除术的187例患者的临床资料。采用logistic回归分析临床指标与切缘的相关性，并且采用Cox回归探讨切缘阳性组中发生前列腺特异性抗原(PSA)进展的独立危险因素。结果 穿刺前总前列腺特异性抗原(tPSA)、前列腺成像报告和数据系统(PI-RADS)评分、前列腺穿刺阳性针数百分比、术后病理分期、预后风险分组为前列腺术后切缘阳性的独立预测因素，而穿刺前tPSA、切缘阳性数目、术后Gleason评分及术后病理分期为切缘阳性组中发生PSA进展的独立危险因素。结论 穿刺前高tPSA、术后病理高分期既是切缘阳性又是导致其疾病进展的关键危险因素，需密切监测和积极治疗。更多还原

【Abstract】 Objective To analyze the risk factors of positive surgical margin(PSM) after radical prostatectomy, and to explore the high-risk factors of prostate-specific antigen(PSA) progression in patients with PSM.Methods The clinical data of 187 patients who underwent radical prostatectomy in the First Hospital of Shanxi Medical University during Aug.2018 and Aug.2021 were retrospectively analyzed.The correlation between clinical indexes and PSM was analyzed with logistic regression.The independent risk factors of PSA progression were analyzed with Cox regression.Results Pre-biopsy total prostate-specific antigen(tPSA), prostate imaging-reporting and date system(PI-RADS) score, biopsy positive score(BPC), postoperative pathological stage and prognostic risk group were independent predictors of PSM, while pre-biopsy tPSA, number of PSM, postoperative Gleason score and postoperative pathological stage were independent risk factors of PSA progression.Conclusion High pre-biopsy tPSA and high postoperative pathological stage are risk factors of PSM and PSA progression, which requires close monitoring and active treatment.更多还原