前列腺增生术后发生前列腺癌12例报告

Prostate cancer after prostectomy for benign prostatic hyperplasia (Reports 12 cases)

目的 :探讨前列腺增生 (BPH)术后发生前列腺癌 (PCa)的临床特征。方法 :报告 12例BPH术后发生PCa患者的临床资料 ,PCa距BPH手术时间为 10个月～ 14年 ,平均 5 .6年。患者BPH后因尿频、尿急、排尿困难、血尿、疼痛而再次就诊。检查血清PSA异常 11例 ,前列腺结节 8例。B期 3例、C期 3例、D期 6例。 12例均行双侧睾丸切除术 [白膜下睾丸切除 4例 ,3例行经尿道前列腺电切术 (TURP) ]。联合雄激素阻断治疗 10例 ;内照射治疗骨痛 3例。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 ,1例失访。结论 :BPH手术不能预防PCa的发生 ;血清PSA和直肠指检是BPH术后前列腺癌诊断的主要方法。

Objective:To study the diagnosis and treatment of prostate cancer after prostectomy for benign prostatic hyperplasia(BPH).Methods:Twelve cases of prostate cancer post-prostectomy for benign disease were reviewed and studied. The mean intervals between prostectomy for BPH and the diagnosis of prostate cancer was 5.6 years (duration 10 months to 14 years). 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 done in 12 cases. Three patients with urinary tract obstruction received additional treatment of TURP.Results:Following up for 4 months to 8 years, 3 patients died, 6 patients had stable disease and disease progression was found in 2 cases.Conclusions:The surgery for BPH could not prevent developing of prostate cancer. PSA and DRE were the main methods in diagnosing of this prostate cancer.