首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 217 毫秒
1.
前列腺癌的早期诊断   总被引:1,自引:0,他引:1  
前列腺癌(PC)是一种极为特殊的肿瘤,早期诊断、及时治疗是提高PC患者生存率的关键。探讨国内外有关PC的早期诊断方法,重视PC的危险信号,重视危险人群的检查、直肠指诊(DRE) 、经直肠超声及前列腺特异抗原,是目前临床上筛查PC的主要方法,磁共振波谱成像( MRS)对前列腺节结的鉴别有重要意义,确诊依靠前列腺穿刺活检。  相似文献   

2.
前列腺癌是男性泌尿生殖系统常见的恶性肿瘤,患者多数无明显临床症状,常在直肠指检时偶然发现,也可在前列腺增生手术标本中发现。早期诊断、及时治疗是提高前列腺癌患者疗效的重要措施。但目前对前列腺癌的早期筛查仍停留在检测血清前列腺特异性抗原(PSA)水平上,而PSA对于前列腺癌诊断的特异性不高,存在一定局限性。近年研究发现,前列腺癌抗原基因3(PCA3)可能为前列腺癌的特异性标志物。本文就该领域的前沿进展做一小结。  相似文献   

3.
前列腺癌是全球性的公共健康挑战。前列腺特异性抗原(PSA)作为基础筛查显著提高了前列腺癌诊断率,但潜在的副作用不容忽视。前列腺癌筛查能否降低死亡率仍有争议,数个大样本临床研究的结论莫衷一是。欧洲前列腺癌筛查随机研究以及瑞典哥德堡研究显示筛查降低死亡率,而美国前列腺、肺、结直肠和卵巢癌筛查研究的结论相反。对前列腺癌筛查的担忧主要包括筛查本身的并发症以及对惰性前列腺癌的过度诊断和治疗。目前总体证据支持进行前列腺癌筛查,但需要采取措施积极改进筛查的策略。  相似文献   

4.
目的 评价经直肠超声引导下"13+X"前列腺穿刺活检诊断前列腺癌的临床应用价值.方法 回顾性分析血PSA升高和(或)直肠指检前列腺结节及前列腺MRI示外周带有异常信号的61例患者经直肠超声引导下前列腺穿刺活检的临床资料.结果 61例患者中,诊断为前列腺癌24例,阳性率为39.4%;前列腺增生29例,占47.5%;PIN 6例,占9.8%前列腺脓肿2例,占3.3%.均未出现严重并发症.结论 经直肠超声引导下前列腺"13+X"点穿刺是筛查前列腺癌的一种安全、有效检查方法,在临床早期诊断前列腺癌具有重要价值.  相似文献   

5.
前列腺癌严重危害国民生活质量,虽然前列腺特异性抗原(PSA)已广泛用于前列腺癌的诊断和筛查,并且有效降低了前列腺癌的死亡率,但以PSA为依据的全面筛查前列腺癌有过度医疗之嫌。因此发现更为有效的筛查手段显得尤为重要,详读国内外最新前列腺癌早期筛查文献报道,就PSA前体与多参数MRI(mpMRI)对早期筛查的意义做一综述。  相似文献   

6.
He Y  Qin GD  Xiao MZ 《中华男科学杂志》2011,17(11):1029-1032
肿瘤的生物标志物研究对肿瘤的早期诊断和治疗有重要意义。虽然前列腺特异性抗原(PSA)用于临床前列腺癌的筛查和治疗效果评价已经20余年,但是其效果并不能完全让人满意。随着对前列腺癌研究的深入,目前已经发现了多种前列腺癌的生物标志物。本文就前列腺癌生物标志物筛查的临床研究进展进行综述。  相似文献   

7.
目的 通过分析集团筛查和临床诊断发现的前列腺癌,探讨前列腺癌筛查的临床价值.方法 2000年1月至2008年1月共收治441例前列腺癌患者,分为两组,临床组为门诊收治的前列腺癌患者122例;筛查组为同期23 183名50岁以上男性人群筛查发现的前列腺癌患者319例(均住院治疗);对两组患者年龄、直肠指检阳性率、血清前列腺特异性抗原(PSA)、病理Gleason评分、分型及临床分期和治疗方法等进行比较.结果 筛查组直肠指检阳性率为42.0%,低于临床组的79.5%.筛查组中PSA>20.0 μg/L的比例低于临床组.筛查组的中度分化腺癌占61.8%,高于临床组的29.5%,而低分化腺癌则相反.筛查组低于T2的患者比例为56.1%,T3以上患者比例为43.9%;临床组低于T2的患者比例为25.4%,T3以上患者比例为74.6%.发生局部及远处转移患者,筛查组26.0%,临床组46.0%.临床组根治性前列腺切除术占9.8%;筛查组根治手术占18.2%.结论 人群中筛查前列腺癌可以发现早期局限无症状的前列腺癌.  相似文献   

8.
目的探寻早期诊断前列腺癌的方法。方法应用超声弹性成像(UE)技术,对56例前列腺增生伴PSA增高或正常患者,同时行经直肠前列腺二维超声及UE检查,比较普通经直肠超声检查联合PSA与UE联合PSA对前列腺癌诊断的敏感性和特异性。结果以穿刺活检为判断前列腺癌的标准,UE联合PSA无论是敏感性(75.0%)、特异性(85.0%)和符合率(82.1%)均高于普通经直肠超声检查联合PSA敏感性(62.5%)、特异性(15.0%)和符合率(28.6%),差异具统计学意义(P0.05)。结论 UE无痛无创,简便易行,其与PSA相结合对前列腺癌的诊断,比经直肠超声检查联合PSA更具有临床价值,值得推广。  相似文献   

9.
目的 :提高前列腺癌的诊断水平。方法 :回顾分析 10 3例前列腺癌的临床资料 ,对前列腺癌的诊断方法进行探讨。结果 :单项PSA ,直肠指检 (DRE)及经直肠前列腺超声 (TRUS)检查诊断阳性率为 65 .9%~ 90 .3 % ,而前列腺穿刺诊断阳性率 95 .1%。结论 :前列腺穿刺活检对诊断前列腺癌具有重要意义。PSA、DRE、TRUS与前列腺穿刺结合可提高诊断的阳性率与准确率。  相似文献   

10.
前列腺早期临床症状轻微 ,本文从 :①前列腺特异抗原系统 (PSASystem) ;②直肠指诊 (DRE) ;③经直肠超声成像 (TRUS) ;④活检 (Biopsy) ;⑤前列腺特异性膜抗原 (PSMA) ;⑥端粒酶活性测定 (TRAP)等六个方面总结了近年代表性的观点及研究现状 ,得出它们的联合应用对前列腺癌 (PCa)的早期诊断有重要意义  相似文献   

11.
We have analysed the reasons for the low reported incidence of prostate cancer in China and argue for early diagnosis and treatment of this disease. According to the 2002 database of the International Agency for Research on Cancer (IARC), the age-standardized incidence of prostate cancer in China is 1.6/105 person years (PY), with a mortality rate of 1.0/105 PY and mortality-to-incidence rate ratio (MR/IR) = 0.63. The MR/IR ratio of prostate cancer in China was found to be higher than the average in Asia (MR/IR = 0.57) and much higher than that in North America (MR/IR = 0.13). These data indicate that in China most prostate cancers were in the advanced stages at the time of diagnosis, and that patients had a short survival time thereafter. In 2004, Stamey et al. reported a retrospective American study of prostate cancer for the years 1983-2003. It was shown that most cases of prostate cancer detected by prostate-specific antigen (PSA) screening were in the advanced stage at the start of this 20-year period. These early follow-up data are quite similar to the results obtained from mass PSA screening of elderly men in Changchun, China. However, after the American programmes for early diagnosis and treatment of prostate cancer were accepted, tumours were diagnosed at earlier stages. On the basis of these findings, mass screening should be performed in the whole of China using serum PSA to facilitate early diagnosis and treatment of prostate cancer.  相似文献   

12.
前列腺癌标志物研究进展   总被引:3,自引:2,他引:1  
前列腺癌是男性泌尿系统常见的恶性肿瘤之一,近年来其发病率在我国呈上升趋势。前列腺癌的最常用检测标志物就是前列腺特异性抗原(PSA),随着人们对PSA的不断认识,逐渐发现PSA的组织特异性较高,而癌特异性较差,其临床应用价值也有待重新评估,因此大量研究转向寻找新的前列腺癌标志物,目前已取得不少成果。本文从DNA、RNA和蛋白质水平三方面阐述前列腺癌标志物的研究进展,以期为前列腺癌的诊断和治疗提供新途径。  相似文献   

13.
前列腺癌的发病率逐年增加,早期诊断及治疗对于控制疾病的发展至关重要。CEUS作为一项新的检查手段,不仅可提高前列腺癌的诊断水平,而且可用于前列腺癌的治疗。本研究对CEUS在PCa诊治中的应用进展进行综述。  相似文献   

14.
为在我国实现前列腺癌早期发现、早期诊断与治疗的目的 ,对 5 0岁以上男性进行PSA集团普查 ,以集团普查癌与临床前列腺癌进行对比分析 ,证明只有通过人群普查才能发现早期前列腺癌并为病人提供根治的机会。同时探讨了前列腺癌的治疗现状与存在的问题 ,对前列腺癌未来研究方向进行了展望  相似文献   

15.
前列腺特异性膜抗原在前列腺癌诊治中的研究进展   总被引:2,自引:1,他引:1  
近年来,前列腺癌特异性的分子标志物——前列腺特异性膜抗原(PSMA)已成为前列腺癌临床研究中的热点之一。PSMA在前列腺癌的早期诊断、基因治疗、预后评估中所起的作用变得越来越重要。本文就PSMA蛋白的结构、功能、表达特点、基因表达以及基于PSMA的前列腺癌放射免疫显像、DNA疫苗、自杀基因治疗的相关研究进展及其在前列腺癌诊治中的作用进行了综述。  相似文献   

16.
Prostate-specific antigen (PSA) testing for the early diagnosis of prostate cancer has led to a decrease in cancer mortality. However, the high prevalence of low-grade prostate cancer and its long natural history, competing causes of death in older men and treatment patterns of prostate cancer, have led to dramatic overtreatment of the disease. Improved markers of prostate cancer lethality are needed to reduce the overtreatment of prostate cancer that leads to a reduced quality of life without extending life for a high proportion of men. The PSA level prior to treatment is routinely used in multivariable models to predict prostate cancer aggressiveness. PSA isoforms and PSA kinetics have been associated with more aggressive phenotypes, but are not routinely employed as part of prediction tools prior to treatment. PSA kinetics is a valuable marker of lethality post treatment and routinely used in determining the need for salvage therapy.  相似文献   

17.
樊嘉 《中国实用外科杂志》2019,39(10):1010-1014
肝癌作为我国最常见的恶性肿瘤之一,其疾病背景和临床诊治与国外有所不同,具有中国特色。近年来,我国在肝癌诊疗和研究方面取得了长足的进步。在肝癌的早期诊断方面,以循环微小核糖核酸(miRNA)、循环肿瘤细胞(CTC)、循环肿瘤DNA(ctDNA)为代表的液体活检技术取得一系列进展和成果,极大推动了肝癌的早诊早治。在手术治疗方面,通过不断探索新的手术方式、手术适应证以及术后转移复发干预策略,使更多病人得到手术切除机会,同时降低了术后肝癌转移复发的风险,显著延长病人总生存时间。此外,肝癌临床研究日益受到重视,部分临床试验的结论作为重要的循证医学证据,指导肝癌诊疗规范推陈出新,为我国肝癌病人“量体裁衣”,更加符合中国肝癌的疾病特点。  相似文献   

18.
Prostate specific antigen (PSA) was introduced as a prostate cancer screening tool more than 20 years ago. However, there is continuing debate regarding its utility in screening for prostate cancer. Mass screening is costly, may result in the diagnosis and treatment of prostate cancers that never become clinically significant, and the evidence of a subsequent reduction in mortality is inconclusive. In addition to its role in screening, PSA is also used to monitor the progression of the disease, both localized and metastatic. Although the evidence is contradictory, PSA is still an important tool for monitoring patient progression following treatment of definitive localized prostate cancer. However, its use in monitoring castrate-resistant prostate cancer (CRPC) is more controversial, particularly in the context of novel targeted treatments, which may have little impact on PSA levels. These issues highlight the urgent need to identify prostate cancer biomarkers that will improve early disease detection, increase accuracy of diagnosis, determine the aggressiveness of disease, and monitor treatment efficacy, particularly in late-stage disease. This review discusses the key issues associated with the use of PSA as an early screening tool for prostate cancer, as a prognostic marker to measure disease progression in both early- and late-stage prostate cancer, and as a surrogate endpoint in clinical trials with new agents.  相似文献   

19.
The natural history of prostate cancer   总被引:1,自引:0,他引:1  
Predicting the long-term outcome of patients who choose watchful waiting as initial therapy for prostate cancer is difficult. The wide variation in disease progression, the impact of competing medical hazards, and the potential impact of early hormonal therapy that is characteristic of contemporary patients all conspire to compromise survival estimates dating from the pre-PSA era. The survival analysis figure developed by Albertsen et al (Fig. 1) estimates a 15-year survival rate based on patient age and Gleason score at diagnosis from patients diagnosed in the pre-PSA era. Although no effort was made to adjustfor competing medical hazards, patients and clinicians can adjust a patient's chronological age to match his "physiological" age. The advent of widespread PSA testing appears to have advanced the date of diagnosis by approximately 5 years and the onset of secondary treatment by at least as many years. Therefore, the figure describing the natural history of prostate cancer most likely underestimates rather than overestimates survival among men with newly diagnosed, localized prostate cancer who select watchful waiting as their treatment choice. As contemporary databases of men with localized prostate cancer mature, more data on the natural history of this disease will become available. Only time will tell how the use of PSA has altered the precision of historic case-series data.  相似文献   

20.
Advances in the diagnosis of early stage disease, and particularly the introduction of prostate-specific antigen (PSA) testing, have had a dramatic effect on the presentation and clinical management of prostate cancer during the past ten years. As a result, there have been significant epidemiological changes in countries where early diagnosis is recommended. The importance of PSA testing for the diagnosis of localized prostate cancer has become well established in clinical practice and this is reflected by improved outcomes from definitive treatment. The contribution of PSA-related parameters and molecular forms of PSA both to cancer detection and prediction of pathological stage continue to be explored. Concerns about the reliability of the standard sextant biopsy technique for cancer detection relate to the need for re-biopsy in a growing number of patients with negative biopsies and an increasing proportion of patients with low volume, multifocal disease. In men with cancer, additional prognostic information can be derived from biopsy findings, with important therapeutic implications. This relates also to the need for reliable markers indicating pathological stage and risk of progression. The opportunities for the prevention of prostate cancer have grown with improved understanding of its biology and the genetic basis of the early steps associated with malignant transformation. In the future, the need for therapeutic intervention is likely to be most influenced by successful prevention strategies.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号