前列腺导管腺癌临床特点和诊治方法分析及文献复习(附7例报告)  

Clinical diagnosis and treatment of prostatic ductal adenocarcinoma and review of literature(report of 7 cases)

作　　者：彭超 张俊[1] 徐晓健[1] 王亮良[1] 袁和兴[1] 黄玉华[1] 侯建全[1] PENG Chao;ZHANG Jun;XU Xiao-jian;WANG Liang-liang;YUAN He-xing;HUANG Yu-hua;HOU Jian-quan(Department of Urology,First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院泌尿外科,215000

出　　处：《现代泌尿生殖肿瘤杂志》2018年第4期236-240,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的分析探讨前列腺导管腺癌(PDA)的临床特点、诊断及治疗方法,提高临床及病理医生对PDA的认识。方法回顾性分析2008年3月至2017年11月我院泌尿外科收治的7例PDA患者的病例资料,结合文献复习进行研究。结果 7例患者年龄48～84岁,平均71岁,5例有不同程度的排尿困难,其中1例伴有明显肉眼血尿;2例体检发现PSA升高。所有患者均经病理检查证实为PDA,4例患者行前列腺根治性切除术,3例患者行TURP+药物去势治疗,其中1例患者术前误诊为良性前列腺增生。所有患者术后随访4～36个月,行TURP的3例患者有2例短期内出现多发骨转移及肝脏转移,分别于术后4个月和5个月死亡,1例术后7个月出现生化复发,其余行根治性切除术的4例患者恢复良好,至今无生化复发。结论 PDA早期诊断困难易误诊,较前列腺腺泡癌恶性程度更高,预后更差。早期诊断,积极的根治性切除术并辅以内分泌治疗可有效改善患者的预后。Objective To explore the clinical features, diagnosis and treatment of prostatic ductal adenocarcinoma （PDA）.Methods The clinical data of 7 cases of PDA were retrospectively analyzed. Patient′s average age was 71 （range, 48-84） years old. Five cases were presented with dysuresia, and 1 of them had the painnless gross hematuria. Two cases were detected the elevated serum PSA in the routine healthy examination. Radical prostatectomy （RP） were performed in 4 cases; 3 cases underwent transurethral resection of the prostate （TURP）.Results Seven patients had been followed up 4-36 months. Two patients developed multiple liver and bone metastases and died shortly after, 1 patient experienced biochemical recurrence 7 months after surgery. The other 4 patients who underwent RP have yet to experience biochemical recurrence.Conclusions PDA is very difficult to be diagnosed during the early stage, and tends to pursue more aggressive clinical course and poorer prognosis. Early diagnosis and active surgical treatment can improve the prognosis of patients. Endocrine therapy has become an essential treatment plan for PDA at present and has obvious curative effect.

关 键 词：前列腺肿瘤 导管腺癌 根治性切除 内分泌治疗 

分 类 号：R737.25[医药卫生—肿瘤]