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目的提高对前列腺小细胞癌的认识,探讨其诊治方法。方法分析2005年4月收治的1例前列腺小细胞癌患者的临床资料,并进行文献复习。患者65岁,因尿急1月,直肠指诊前列腺右叶突起明显,质地硬入院。血PSA1.92ng/ml。MRI:前列腺右侧肿块侵犯右侧膀胱精囊三角,并与直肠前壁相连。前列腺穿刺病理示:小细胞癌。行手术去势和前列腺与盆腔区域放疗。治疗失败后行EP方案化疗。结果内分泌治疗无效,2月后病情进展,广泛转移,患者骨痛,吞咽困难,血肿瘤标志物如NSE等升高。化疗有效,患者症状明显改善,血肿瘤标志物水平下降,可测量病灶稳定。化疗5疗程后病情进展,2006年3月18日死亡。结论前列腺小细胞癌预后差,内分泌治疗无效,化疗在治疗中占有重要地位。
Objective To improve the awareness of small cell carcinoma of the prostate and to explore its diagnosis and treatment. Methods The clinical data of one patient with small cell carcinoma of the prostate treated in April 2005 were analyzed and reviewed. Patients 65 years of age, due to urinary urgency in January, rectal examination of the right prostate lobes prominent, hard-quality admission. Blood PSA1.92ng / ml. MRI: The right prostate mass invades the triangle of the right vesicle and connects to the anterior wall of the rectum. Prostate puncture pathology: small cell carcinoma. Surgical castration and prostate and pelvic area radiotherapy. After the failure of EP chemotherapy. Results Endocrine therapy was ineffective. After 2 months, the disease progressed, extensive metastasis, bone pain, dysphagia, and hematological markers such as NSE increased. Chemotherapy effective, patients with symptoms improved significantly, blood tumor markers decreased, the measurable lesions stable. Chemotherapy after 5 courses of disease progression, March 18, 2006 death. Conclusions Prostatic small cell carcinoma has poor prognosis and endocrine therapy is ineffective. Chemotherapy plays an important role in the treatment.