根治性全膀胱切除术后偶发前列腺癌的诊断与治疗

Diagnosis and Treatment of Incidental Prostate Cancer After Radical Total Radical Resection of the Bladder

目的讨论根治性全膀胱切除术后偶发前列腺癌患者的临床特点,以提升对偶发前列腺癌的认识和诊治水平。方法回顾性分析2012年2月-2015年5月我院行膀胱癌行根治性全膀胱切除术后偶发前列腺癌的10例患者资料。结果 10例术前检查PSA正常3例,TPSA异常1例,6例患者术前未查TPSA。5例行腹腔镜全膀胱切除,5例行开放全膀胱切除。随访1-8月,共有9例患者完成随访,1例失访,9例患者PSA处于正常范围之内（〈4 ng/ml）。其中,1例围手术期死于心梗,1例死于远处转移,7例存活至今（70%）。结论前列腺偶发癌缺少特异性的临床表现,其诊断有赖于病理学检查,治疗依据患者的年龄、肿瘤体积、分化程度等确定治疗方案,以期提升患者的治疗效果。

Objective To discuss the clinical characteristics of patients with incidental prostate cancer after radical total radical resection of bladder in order to improve the understanding and diagnosis and treatment of incidental prostate cancer. Methods From February 2012 to May 2015 in our hospital, we retrospective analysis of 10 cases of incidental prostate cancer after radical total radical resection of bladder cancer. Results 10 cases of preoperative examination of PSA were normal in 3 cases, 1 cases of abnormal TPSA, 6 cases of patients without preoperative examination of TPSA. 5 cases underwent laparoscopic radical resection and 5 cases underwent open radical resection. Follow up for 1 to 8 months, a total of 9 patients completed follow-up, 1 patients lost to follow-up, 9 cases of patients with PSA in the normal range（4 ng/ml）. 1 patients died of myocardial infarction, 1 died of distant metastasis, and 7 survived so far（70%）. Conclusion the clinical manifestations of incidental prostate cancer lack of specificity, and its diagnosis depends on pathological examination, treatment according to the patient＇s age, tumor size and differentiation degree determine the treatment, in order to improve the therapeutic effect of patients.