前列腺导管腺癌45例报告并文献复习  

Ductal adenocarcinoma of the prostate:Report of 45 cases and review of the literature

作　　者：李超 龙智[1] 邓梁 何强荣 ALSHARAFI Bassam Lutf Mohammed 周恒峰 王龙 何乐业[1] 甘宇 LI Chao;LONG Zhi;DENG Liang;HE Qiang-rong;ALSHARAFI Bassam Lutf Mohammed;ZHOU Heng-feng;WANG Long;HE Le-ye;GAN Yu(Department of Urology,The Third Xiangya Hospital,Central South University,Changsha,Hunan 410013,China;Department of Urology,Xiangya Hospital,Central South University,Changsha,Hunan 410008,China)

机构地区：[1]中南大学湘雅三医院泌尿外科,湖南长沙410013 [2]中南大学湘雅医院泌尿外科,湖南长沙410008

出　　处：《中华男科学杂志》2022年第2期129-134,共6页National Journal of Andrology

基　　金：国家自然科学基金青年基金(81902606);湖南省卫生厅科研基金(C2016071);湖南省自然科学基金青年基金(2020JJ5891)。

摘　　要：目的:探讨前列腺导管腺癌(DAP)的临床特征、治疗方式及预后,提高对DAP的认识。方法:回顾性分析2013年1月至2020年9月中南大学湘雅三医院泌尿外科收治的45例DAP患者的临床资料,比较两组行根治术(RP)DAP患者(中危组13例,高危组11例)生化复发时间、生化复发率及影像学进展率;分析姑息性经尿道双极等离子前列腺电切术(pTU-PKRP)改善DAP患者下尿路症状(LUTS)的疗效。结果:4例(4/45,8.9%)为单纯型DAP,41例(41/45,91.1%)DAP合并前列腺腺泡癌(PAA)。混合型病例中,9例(9/41,21.9%)同时合并神经内分泌分化,4例(4/41,9.8%)合并导管内癌。中危组较高危组生化复发时间延长(P<0.05),两组生化复发率和影像学进展率无显著差异(P>0.05);pTU-PKRP术后6个月的Qmax、PVR、IPSS及QoL较术前有显著改善(P<0.05)。结论:早期DAP患者积极行RP术可改善预后,对于合并严重LUTS的中晚期DAP患者,pTU-PKRP术可改善其生活质量。Objective:To explore the clinical features,treatment and prognosis of ductal adenocarcinoma of the prostate(DAP)and get a deeper insight into the malignancy.Methods:We retrospectively studied the clinical data on 45 cases of confirmed DAP,26 in the high-risk group and 19 in the medium-risk group,treated from January 2013 to September 2020.We compared the time and rate of biochemical recurrence and the rate of imaging progression between the two groups of patients,and evaluated the effect of palliative transurethral bipolar plasma resection of the prostate(pTU-PKRP)on the lower urinary tract symptoms(LUTS).Results:Of the 45 cases of DAP,4(8.9%)were of the simple type,and 41(91.1%)complicated by prostatic acinar carcinoma(PAA).And of the latter 41 cases,9(21.9%)were complicated by neuroendocrine differentiation and another 4(9.8%)by intraductal carcinoma.The time to biochemical recurrence was longer in the medium-risk than in the high-risk group(P<0.05).No statistically significant differences were observed in the rates of biochemical recurrence and imaging progression between the two groups(P>0.05).The maximum urinary flow rate(Qmax),postvoid residual urine volume(PVR),IPSS and QOL of the patients were significantly improved at 6 months after pTU-PKRP compared with the baseline(P<0.05).Conclusion:Radical prostatectomy can improve the prognosis of early DAP,while for advanced DAP with serious LUTS,pTU-PKRP can improve the quality of life of the patients.

关 键 词：前列腺癌 前列腺导管腺癌 治疗 预后 

分 类 号：R737.25[医药卫生—肿瘤] R697.3[医药卫生—临床医学]