前列腺泡沫状腺癌诊疗分析  

Prostatic foamy gland carcinoma:diagnosis and treatment

作　　者：杨虎[1] 潘家骅[1] 董柏君[1] 宣寒青[1] 沙建军[1] 陈勇辉[1] 李东[1] 薛蔚[1] 黄翼然[1] 

机构地区：[1]上海交通大学医学院附属仁济医院,上海200127

出　　处：《现代泌尿外科杂志》2015年第3期151-155,共5页Journal of Modern Urology

基　　金：国家自然科学基金(No.91129725);上海市科委项目(No.14140901700);浦东新区卫生系统重点学科群建设(No.PWZxq2014-05)

摘　　要：目的探讨前列腺泡沫状腺癌的临床病理特征、诊断、治疗及预后。方法回顾性分析2004年5月至2014年5月上海交通大学医学院附属仁济医院收治的15例前列腺泡沫状腺癌患者的临床资料,并结合相关文献进行讨论。结果患者年龄49~85岁,平均（69.53±8.97）岁,主要症状为进行性排尿困难,Gleason评分：6分1例,7分6例,8分4例,9分4例。9例行双侧睾丸切除术,6例行前列腺癌根治术。睾丸切除术患者术前PSA 27.1~153ng/mL,平均（79.37±57.52）ng/mL;术后1月PSA0.13~2.86ng/mL,平均（0.83±1.01）ng/mL;Nadir PSA 0.002~1.33ng/mL,平均（0.37±0.45）ng/mL;达到Nadir PSA时间8~23月,平均（17.23±5.28）月;7例经12~42月出现去势抵抗,平均为（26.43±9.55）月;发生转移5例;9例患者中2例失访,3例死于晚期前列腺癌,4例存活;随访时间平均（60.86±22.11）月。前列腺癌根治术患者术前PSA 11.47~128ng/mL,平均（43.40±43.13）ng/mL;术后1月PSA 0.072~0.36ng/mL,平均（0.17±0.11）ng/mL;Nadir PSA 0.008~0.22ng/mL,平均（0.11±0.07）ng/mL;达到Nadir PSA时间24~42月,平均（33.17±7.28）月;5例经12~60个月出现生化复发,平均为（35.20±17.43）月,复发后1例予康士得及诺雷德治疗,4例予氟他胺治疗,目前生存状况尚可;发生转移3例;6例患者均存活;随访时间平均（53.00±28.04）月。结论前列腺泡沫状腺癌是一种侵袭性强、预后较差的特殊组织学亚型的高级别腺癌。Objective To explore the clinicopathological features ,diagnosis ,treatment and prognosis of prostatic foamy gland carcinoma .Methods We retrospectively analyzed data of 15 patients diagnosed with prostatic foamy gland carcinoma during May 2004 and May 2014 treated in our hospital and reviewed related literatures .Results Patients＆#39;age ranged from 49 to 85 years ,average（69 .53 ± 8 .97）years .Patients mainly manifested progressive dysuria .Gleason score was as the following ：1 case was 6 ,6 cases were 7 ,4 cases were 8 and 4 cases were 9 .Of all patients ,9 received bilateral orchiectomy ,and 6 under‐went radical prostatectomy .For patients receiving orchiectomy ,the preoperative PSA was 27 .1-153 ng/mL ,average（79 .37 ± 57 .52）ng/mL;the PSA 1 month after operation was 0 .13-2 .86 ng/mL ,average （0 .83 ± 1 .01）ng/mL;the nadir PSA was 0.002-1 .33 ng/mL ,average （0 .37 ± 0 .45）ng/mL;time to nadir PSA was 8 -23 months ,average （17 .23 ± 5 .28） months . During the follow‐up of 60 .86 months ,7 patients presented castration resistance after 12 to 42 months with an average of （26.43 ± 9.55） months ,5 had metastasis ,2 were lost to follow ,3 died of advanced prostate cancer and 4 were alive .The mean follow‐up time was （60 .86 ± 22 .11）months .For patients who underwent radical prostatectomy ,the preoperative PSA was 11.47-128 ng/mL ,average （43 .40 ± 43 .13）ng/mL;the PSA 1 month after operation was 0 .072 -0 .36 ng/mL ,average （0.17 ± 0 .11）ng/mL;the nadir PSA was 0 .008 -0 .22ng/mL ,average （0 .11 ± 0 .07）ng/mL;time to nadir PSA was 24 -42 months ,average （33.17 ± 7.28） months .During the follow‐up of 53 .00 months ,5 patients presented biochemical recurrence after 12 to 60 months ,average （35 .20 ± 17 .43） months .After recurrence ,1 patient was treated with Casodex and Zoladex , and 4 were treated with Flutamide .Their general condition was good currently .Three patients had metastasis .All of the 6 pa‐tients were alive .The mean follow‐u

关 键 词：前列腺 腺癌 泡沫状腺体 

分 类 号：R737[医药卫生—肿瘤]