前列腺癌的诊断和治疗现状的探讨

The Current Situation of Diagnosis and Treatment of Prostate Cancer

目的通过290例前列腺癌病例来探讨前列腺癌诊断和治疗的现状。方法回顾山东省立医院自1993年5月至2007年11月入院的290例前列腺癌患者的临床资料,按照tPSA≤4ng/ml,4ng/ml<tPSA≤10ng/ml,10ng/ml<tPSA≤20ng/ml,tPSA>20ng/ml分成A、B、C、D四组。结果 PSA应常规检测,fPSA对于灰区的诊断尤为重要。然而实际上我们只注重tPSA的检测,fPSA很少应用。结论我们证实了指南中穿刺指征的正确性,然而我们实施情况和指南还有差距。本研究没有能证实指南中骨扫指征的正确性,并且认为PSA≤20ng/ml或Gleason评分≤7分,骨转移的阳性率并不低。与指南规定的治疗原则相比,我们还需要努力,如M1期病人我们不能再实施根治。并且可能因为医生的观念问题和病人的配合问题,指南中介绍的化疗和放疗方案,我们实际上罕有运用。

Objectives We aimed to find the diagnosis and treatment of prostate cancer status in Shandong province .Methods Review of the Shandong Provincial Hospital from May 1993 to November 2007 admission of 290 cases of prostate cancer patients with the clinical data , in accordance with tPSA ≤4ng /ml, 4ng/ml<tP-SA ≤10ng /ml and 10 ng/ml <tPSA≤20ng/ml,tPSA>20ng/ml divided into A, B, C and D groups.Results Positive digital rectal examination or MRI revealed abnormal signal , no matter how many tPSA value should be to prostate biopsy.Study found that the implementation of the two rates were 81.0% and 80.3%.Conclusions Perhaps because the sense of doctors and patients cope with the problem , the guide introduced by the chemother-apy and radiotherapy , we actually rarely use .Prostate cancer patients with early diagnosis of the current situation is not optimistic, the majority of patients had a diagnosis of invasive or distant metastasis (61.7%), therefore, the current main treatment of prostate cancer is surgical castration method for drug and anti -androgen treat-ment.To improve the early prostate cancer diagnosis rate , we propose tPSA, fPSA and DRE, such as the joint application .The good news is that the diagnosis and treatment of prostate cancer is the rapid improvement in the status quo.The study found that, prior to 2000, only four of radical prostatectomy (11.8%), 2000-2003 the introduction of radical prostatectomy for the nine cases (26.5%), after 2003 the implementation of radical oper-ation reached 21 cases (61.8%).