前列腺导管腺癌合并黏液腺癌1例报告及文献复习  

Prostate ductal adenocarcinoma with prostate mucinous adenocarcinoma:a case report and literature review

作　　者：尼哈提·热夏提 曹宏[2] 韩炜哲 陈志壮 史嘉庚 伍庄 吕源 江春勇 刘涛[1] 王永志 王行环[1] 杨中华[1] NIHATI Rexiati;CAO Hong;HAN Weizhe;CHEN Zhizhuang;SHI Jiageng;WU Zhuang;LYU Yuan;JIANG Chunyong;LIU Tao;WANG Yongzhi;WANG Xinghuan;YANG Zhonghua(Department of Urology,Zhongnan Hospital of Wuhan University,Wuhan 430072;Department of Pathology,Zhongnan Hospital of Wuhan University,Wuhan 430072;Department of Urology,China Resources WISCO General Hospital,Wuhan University of Science and Technology,Wuhan 430072;Department of Urology,Huangmei County People s Hospital,Huanggang 435500;Department of Urology,Danjiangkou First Hospital,Danjiangkou 442700,China)

机构地区：[1]武汉大学中南医院泌尿外科,湖北武汉430072 [2]武汉大学中南医院病理科,湖北武汉430072 [3]武汉科技大学华润武钢总医院泌尿外科,湖北武汉430072 [4]湖北省黄梅县人民医院泌尿外科,湖北黄冈435500 [5]湖北省丹江口市第一医院泌尿外科,湖北丹江口442700

出　　处：《现代泌尿外科杂志》2024年第12期1055-1059,共5页Journal of Modern Urology

摘　　要：目的总结1例可能系世界首例报告的前列腺导管腺癌(PDA)合并前列腺黏液腺癌(PMA)患者的临床表现、病理学特征、治疗及预后情况(查新范围:英文、中文文献)。方法对武汉大学中南医院收治的1例PDA合并PMA患者的临床和随访资料进行回顾性分析,通过检索PubMed、中国知网等数据库进行相关文献复习和总结。结果患者因排尿困难、伴尿频、尿急、尿痛半年余入院就诊。先后入院3次,首次入院诊断为良性前列腺增生合并前列腺脓肿。2个月后因症状加重再次入院,给予经尿道膀胱颈切开术+膀胱镜检查+经尿道前列腺等离子电切术,术后病理诊断为PDA,局部呈PMA。患者术后3个月因间断肉眼血尿第3次入院,辅助检查发现广泛转移,给予内分泌治疗。术后9个月患者因双肺多发转移死亡。结论肿瘤的早期诊断对患者的治疗及预后有重要影响,但PDA合并PMA此前未见报道且早期缺乏特异性标志物而导致漏诊、误诊,PDA合并PMA尚缺乏特异性治疗方法,本例采用根治性前列腺切除术未获满意疗效。Objective To summarize the clinical manifestations,pathological characteristics,treatment options and prognosis of the world s first case of prostate ductal adenocarcinoma(PDA)complicated with prostate mucinous adenocarcinoma(PMA).Methods The clinical and follow-up data of a patient with PDA and PMA treated in Zhongnan Hospital of Wuhan University were retrospectively analyzed,and relevant literature in PubMed and CNKI databases was retrieved.Results The patient sought medical attention due to dysuria,frequent urination,urinary urgency and urinary pain for more than half a year,and was admitted to hospital 3 times in total.The initial diagnosis upon the first admission was benign prostatic hyperplasia complicated with prostatic abscess.After 2 months,the patient was readmitted due to worsening symptoms,received transurethral bladder neck incision+cystoscopy+transurethral plasma resection of the prostate,and postoperative diagnosis confirmed PDA with local PMA.Three months after surgery,the patient had bleeding.After auxiliary examinations revealed extensive metastasis,he received hormonal therapy.After 9 months,the patient died due to multiple lung metastases.Conclusion Early diagnosis has a significant impact on the treatment and prognosis,but there have been no previous reports of PDA combined with PMA,so the lack of specific biomarkers in the early stage has led to missed diagnosis or misdiagnoses.There is no specific treatment for PDA with PMA.Radical prostatectomy was not satisfactory in the treatment of this case.

关 键 词：前列腺癌 导管腺癌 黏液腺癌 前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤]