超声导向经会阴穿刺冷冻治疗中晚期前列腺癌(附20例报告)

Ultrasound-guided percutaneous cryoablation of stage C and D prostate cancer (report of 20 cases)

目的 探讨冷冻治疗中晚期前列腺癌的有效性和安全性。 方法 在B超引导下 ,对2 0例中晚期前列腺癌患者经会阴穿刺液氮冷冻前列腺肿瘤组织 ,检测冷冻前后PSA、穿刺病理活检以及前列腺和肿瘤体积的影像学变化。 结果 2 0例随访 2～ 48个月 ,PSA术前平均 39.2ng/ml(16 .1～ 98.2ng/ml) ,术后 3、6、9、12、2 4、48个月分别为 4.2、3.8、3 .5、3 .6、3.0、3 .1ng/ml。肛诊、B超、CT及MRI示前列腺体积缩小并基本保持稳定。术后 3个月瘤体基本消失 ,仅有少量瘢痕组织。前列腺总体积由术前平均 6 4.2ml降至 2 5 .5ml。术后 6个月行前列腺多点穿刺活检 ,仅 1例阳性。全组均未出现冷冻并发症。 结论 超声导向经会阴穿刺冷冻治疗中晚期前列腺癌是一种安全有效的方法。

Objective To elucidate the efficacy and applicability of cryoablation for stage C and stage D prostate cancer. Methods 20 patients with stage C and stage D prostate cancer were treated with liquid nitrogen by ultrasound guided percutaneous puncture into the tumor was for cryoablation.PSA and the total volume of prostate(including tumors)were observed and recoreded,both before and after operation. Results The average preoperative value of PSA was 39.2 ng/ml,and dropped to 4.2、 3.8 、 3.5 、 3.6 、 3.0 、3.1 ng/ml respectively in the 3rd、6th、9th、12th、24th、48th months after operation.The total volume of prostate decreased in averagely from 64.2 ml preoperative to 25.5 ml.Postoperative biopsies had been positive only in one case in the 6th month.No complications were found in the 20 cases. Conclusions The procedure of US guided percutaneous cryoablation of stage C and stage D prostate cancer is effective and safe.