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目的讨论膀胱移行细胞癌伴前列腺癌的诊断和治疗。方法对389例膀胱移行细胞癌患者中伴有前列腺癌的7例患者资料进行分析。结果 7例患者均经活组织检查和膀胱镜检查诊断为膀胱移行细胞癌,经前列腺穿刺活检,被诊断为前列腺腺癌。3例患者经尿道采用电切术将膀胱肿瘤及双侧睾丸切除,术后用丝裂霉素或者BCG对患者膀胱实施药物灌注,同时口服氟他胺治疗前列腺癌。1例患者的部分膀胱及双侧膀胱被实施切除,并在术后对患者的前列腺癌实施体外辅助放射治疗。3例实施膀胱前列腺全切术加回肠膀胱术。7例患者中,失访2例,随访5例,其中2例发生多发转移导致术后生存时间不到1年,另外3例在术后随访1.5～4.0年,恢复良好,未发现肿瘤复发或者转移。结论前列腺穿刺活检、TRUS、DRE、血清PSA测定、活组织检查和膀胱镜检综合检查是目前诊断前列腺癌伴膀胱移行细胞癌的主要方法。膀胱前列腺根治性切除是取得较好治疗效果的重要因素。
Objective To discuss the diagnosis and treatment of bladder transitional cell carcinoma with prostate cancer. Methods The data of 7 patients with prostate cancer in 389 cases of bladder transitional cell carcinoma were analyzed. Results All the 7 patients were diagnosed as bladder transitional cell carcinoma by biopsy and cystoscopy. After prostate biopsy, they were diagnosed as prostate adenocarcinoma. Three patients underwent transurethral resection of the bladder tumor and bilateral testis via transurethral resection of the bladder. Patients were treated with mitomycin or BCG for postoperative perfusion of the bladder and oral flutamide for the treatment of prostate cancer. One patient’s bladder and bilateral bladder were resected and external adjuvant radiotherapy was performed on the patient’s prostate cancer postoperatively. 3 cases of bladder resection and ileal bladder surgery. Of the 7 patients, 2 were lost to follow-up and 5 were followed up. Among them, 2 patients had multiple metastasis and the survival time was less than 1 year. The other 3 patients were followed up for 1.5 to 4.0 years and recovered well. No tumor recurrence or Transfer. Conclusions Prostate biopsy, TRUS, DRE, serum PSA, biopsy and cystoscopy are the main methods to diagnose prostate cancer with transitional cell carcinoma of the bladder. Prostate radical prostatectomy is to obtain a better therapeutic effect of an important factor.