摘要
目的探讨前列腺偶发癌的发病情况及治疗效果。方法分析1993年1月～2005年12月诊断为良性前列腺增生在本院行耻骨上(后)前列腺切除术或经尿道前列腺切除术(TURP)的患者1473例,其中检出前列腺偶发癌51例。35例行内分泌治疗,16例未予治疗,随访观察。结果1473例患者中,前列腺偶发癌的检出率为3.46%;行耻骨上(后)前列腺切除术患者的检出率为3.61%,与行TURP患者(3.15%)的差异无统计学意义(X^2=0.20,P>0.05);血清前列腺特异性抗原(PSA)<4μg/L者的检出率为2.75%,显著低于PSA≥4μg/L者(6.11%,X^2=8.26,P<0.05)。43例前列腺偶发癌患者得到随访,平均随访时间为(45±23)个月。32例内分泌治疗的患者中,14例死亡,其中3例死于前列腺癌复发转移;11例未予治疗的患者中,6例死亡,其中1例死于前列腺癌复发转移。结论前列腺偶发癌的检出率为3.46%,治疗方法包括观察等待、内分泌治疗、放疗及根治性前列腺切除术等,多数患者可选择观察等待或内分泌治疗。
Objective To investigate the incidence of incidental prostatic carcinoma and analyze the effects of different treatment approaches. Methods From January, 1993 to December, 2005, a total of 1473 patients with a diagnosis of benign prostatic hyperplasia underwent prostatectomy or transurethral resection of the prostate （TURP）, of whom 51 were found to have incidental prostatic carcinoma. In these 51 patients with identified malignancy, 35 received endocrine therapy and 16 were managed by watchful waiting. Results Prostatectomy and TURP resulted in no significant difference in the detection rate of incidental prostatic carcinoma（3.61% vs 3.15%, X^2 = 0.20, P 〉 0.05）. In patients with prostate specific antigen（PSA） level ≥4 μg/L, the detection rate of incidental prostatic carcinoma was 6.11%, significantly higher than that in patients with PSA level 〈4μg/L（2.75 %, X^2 = 8.26, P〈0.05）. Of the 51 patients, 43 were followed up for 8 to 128 months with a mean of （45±23） months. Fourteen of the 32 followed-up patients with endocrine therapy died, of which 3 died from metastasis of recurrent prostatic carcinoma; in the 11 patients with watchful waiting, 6 died and one of them died from metastasis of recurrent prostatic carcinoma. Conclusions According to our results, the incidence of incidental prostatic carcinoma in patients undergoing prostatectomy or TURP is 3.46%. For most of the patients with incidental prostatic carcinoma, watchful waiting or endocrine therapy can be the treatment options.
出处
《上海医学》
CAS
CSCD
北大核心
2008年第2期110-112,共3页
Shanghai Medical Journal
关键词
前列腺肿瘤
癌
偶发
良性前列腺增生
Prostatic neoplasm Cancer, Incidental
Benign prostatic hyperplasia
