前列腺小细胞癌2例报告及文献复习

Small-cell carcinoma of the prostate: A report of 2 cases and review of the literature

目的:探讨前列腺小细胞癌的临床病理特征,提高其临床诊治水平。方法:通过2例前列腺癌治疗后转化为前列腺小细胞癌的病例报告并复习相关文献。结果:2例患者因PSA升高行前列腺穿刺,病理诊断均为前列腺癌,均行最大限度雄激素阻断治疗,治疗后PSA降至正常水平;后因排尿困难行前列腺电切术,术后病理诊断为前列腺小细胞癌,行化疗或放疗,于发现小细胞癌后8～9个月死亡。结论:前列腺小细胞癌可由前列腺腺癌治疗后转化而来,病理转化最可能的机制是长期内分泌治疗所诱发突变。前列腺小细胞癌较前列腺腺癌恶性程度高,预后差。

Objective: To investigate the clinicopathological characteristics and improve the clinical treatment of prostatic small-cell carcinoma(PSCC). Methods: We reported 2 cases of PSCC derived from prostate cancer after treated by androgen blockade and prostate electrotomy and reviewed the relevant literature. Results: Two patients with PSA elevation were diagnosed with prostate cancer by prostatic puncture biopsy and treated by maximum androgen blockade, which reduced their total PSA to the normal level. Later, due to difficult urination, they both underwent prostate electrotomy, followed by chemotherapy or radiotherapy for PSCC confirmed by postoperative pathology. Nevertheless, they died at 8 to 9 months after the discovery of PSCC. Conclusion: PSCC can derive from prostate cancer after treatment, which may be attributed to the pathological mutation induced by long-term endocrine therapy. PSCC is more malignant than prostate cancer, and its prognosis is poor.