摘要
目的:总结和分析前列腺电切术后前列腺偶发癌的临床资料。方法:对2815例前列腺增生患者,通过2年的随访,对其生存情况,前列腺特异性抗原(prostate specific antigen,PSA)进展情况和治疗方法进行总结与回顾。结果:本组患者前列腺偶发癌的发生率为0.85%(24/2815),其中T1a期9例,T1b期15例。2组的术前PSA分别是(2.61±1.02)μg/L和(2.89±0.92)μg/L,差异无统计学意义(P=0.12);术后病理Gleason评分分别是(4.52±0.49)和(7.15±1.22),差异有统计学意义(P=0.032)。T1a组9例患者中有4人选择等待观察,4人接受内分泌治疗,1人接受前列腺癌根治性手术;T1b组15例患者中,3人选择等待观察,11人接受内分泌治疗,1人接受前列腺癌根治性手术。随访2年,2组均未发现肿瘤相关性死亡。结论:T1b期肿瘤在Gleason评分上高于T1a期,无论采取何种治疗方法,2年内患者有着良好的生存率,无显著差异,长期随访的效果有待于进一步研究。偶发癌的再分期对指导治疗和预后有重要意义。
Objective： To summarize and analyze clinical data of incidental prostate cancer （IPCa） after transurethral resection of prostate. Methods： We followed up 2 815 prostate hyperplasia patients for two years. The survival rate, prostate specific antigen （PSA） progression, and therapeutic method were summarized retrospectively. Results：The occurrence rate of incidental prostate cancer was 0.8% （24/2 815）, involving 9 cases at stage T1 a and 15 cases at stage T1 b. The preoperative PSA value was （2.61 ± 1.02） μg/L for T1 a patients and （ 2.89 ± 0.92） μg/L for T1b patients. There was no significant difference between the two groups （ P = 0. 12 ）. However, postoperative Gleason score was （4.52 ± 0.49） and （7.15 ± 1.22） for the patients at T1a and T1b stage, respectively. The difference was significant （P =0. 032）. Among the 9 patients at T1a stage, 4 patients selected watchful waiting, 4 accepted endocrinal therapy, one case underwent radical prostectomy. With regard to the 15 cases at T1b stage, 3 selected watchful waiting, 11 patients accepted endocrinal therapy and one case underwent radical prostectomy. After 2-year follow-up, no tumor-related death occurred in these 2 groups. Conclusion. The Gleason score was higher at stage T1b than that at stage T1a. The patients had good surviving rate during 2-year follow-up period no matter which kind of treatment they accepted. Long-term outcome of IPCa is still under further investigation. Re-staging was quite important for guiding treatment and predicting prognosis.
出处
《肿瘤》
CAS
CSCD
北大核心
2007年第12期1003-1005,共3页
Tumor
关键词
前列腺肿瘤
经尿道前列腺切除术
综合疗法
随访研究
Prostate neoplasm
Transurethral resection of prostate
Combined modality therapy
Follow-up studies
