前列腺导管腺癌1例报告并文献复习

目的：提高对前列腺导管腺癌诊断及治疗的认识水平.方法：回顾性分析1例前列腺导管腺癌患者的诊治过程,并复习相关文献,探讨本病的组织发生和生物学特点.患者73岁,无痛性间歇血尿2年,PSA 0.897ng/ml,膀胱镜检查发现前列腺尿道部肿物,切除后提示为尿道低分化腺癌.术后2个月复发,转诊我院.检查前列腺尖部偏右侧有一直径0.5 cm结节,质硬,行经尿道肿物电切术,病理检查为前列腺导管腺癌,遂行前列腺根治性切除术.结果：患者术后恢复良好,无血尿和尿失禁,随访1年无局部复发和远处转移.结论：前列腺导管腺癌是前列腺癌的一个亚型,相对于腺泡腺癌,其起病隐匿,进展快,侵袭性强.前列腺根治性切除术是有效治疗方法.

Treatment of Ductal Adenocarcinoma of the Prostate (One Case of Report and Review of the Literature)

Objective： To improve the recognition in the diagnosis and treatment of dudtal ad the prostate（DAP）. Methods： Retrospective analysis of one case of prostate diagnosis and treatment of patients with ductal adenocarcinoma and review of the literature to explore the occurrence of this disease and biological characteristics of the organization. A /3-year-old man suffered intermittent painless hematuria for 2 years. The PSA level was 0. 897 ng/ml. The patient underwent transurethral resection of urethral tumor after cystoscopy four months ago, and the pathology showed low differentiated adenocarcinoma of the urethra. He was referred to us for the recurrence of the tumor two months later. The pathology of second-resection of the urethral tumor suggested the suspected DAP. The patient successfully underwent the radical prostatectomy. Results：Postoperative patholo- gy showed the tumor characterized by the presence of tall, pseudostratified, columnar cells with a marked cytolog- ic atypia arranged in papillary, cribriform, invasive glandular or solid pattern. There was partly high grade intra- epithelial neoplasia. The pathologic diagnosis was DAP. Postoperatively, the patient recovered well with no urina- ry incontinence and hematuria. During a follow-up 12 months, the patient had no recurrence. Coa~lasions：DAP is a unique subtype of the prostate cancer and an aggressive tumor with occult growth and a shortened average time to progression compared with acinar adenocarcinoma. Radical prostatectomy is recommended for this disease.