良性前列腺增生术后前列腺癌

Prostate Cancer after Prostatectomy for Benign Prostatic Hyperplasia

目的 :提高对前列腺增生术后前列腺癌的认识。 方法 :回顾总结 1 2例 (年龄 6 3～ 82岁 )前列腺增生术后前列腺癌患者的临床资料。前列腺增生术后 1 0个月～ 1 4年 ,平均 5 .6年 ,发现前列腺癌。患者因排尿困难、血尿、疼痛而再次就诊。发现前列腺特异抗原 (PSA)异常 1 1例 ,前列腺结节 8例。B期 3例、C期 3例、D期 6例。 1 2例均行睾丸切除术 ,其中 1 0例加用雄激素受体阻断剂 ,3例行经尿道前列腺切除术 (TURP)。 结果 :随访 4个月～ 8年 ,平均 4 .5年。死亡 3例 ,病变稳定 6例 ,2例病变进展。 结论 :前列腺增生手术不能预防前列腺癌的发生 。

Objective: To study the diagnosis and treatment of prostate cancer after prostatectomy for benign prostatic hyperplasia(BPH). Methods: Twelve cases of prostate cancer after prostatectomy for benign prostatic hyperplasia were reviewed and studied. The mean intervals between prostatectomy for BPH and the diagnosis of prostate cancer was 10 months to 14 years, 5.6 years on average . The main symptoms were dysuria,hematuria and pain.Serum prostate specific antigen (PSA) was elevated in 11 cases. Digital rectal examination (DRE) was abnormal in 8 cases. Three cases were in clinical stage B, 3 in stage C and 6 in stage D. Ten cases received combined androgen blockade therapy. Monotherapy with surgical castration was given to 2 cases. Three patients with urinary tract obstruction received additional treatment of TURP. Results: During the 4 months to 8 years follow up, 3 patients died, 6 remained stable and 2 deteriorated. Conclusion: Surgery for BPH could not prevent the development of prostate cancer. PSA and DRE were the main methods for the diagnosis of this prostate cancer.