经尿道前列腺电切术治疗前列腺癌粒子植入术后尿潴留(2例报告附文献复习)

目的:观察经尿道前列腺电切术治疗前列腺癌粒子植入术后尿潴留的疗效。方法:2005年到2008年,2例前列腺癌粒子植入术后排尿困难、尿潴留患者,行经尿道前列腺电切术。结果:2例患者手术均获得成功,手术时间平均60 min,原夜尿次数5～6次/夜、现夜尿次数2次/夜,术后患者IPSS症状评分及生活质量评分明显提高。结论:前列腺癌粒子植入术后尿潴留患者应用经尿道前列腺电切仍能够取得明显疗效。     

良性前列腺增生TURP术后病理诊断前列腺癌27例分析

目的探讨前列腺增生症病人经尿道前列腺电切（TURP）术后病理检出前列腺癌的临床特点及治疗措施。方法对三家医院于2003年1月～2006年12月经尿道前列腺电切术（TURP）327例进行回顾性分析,对比术后病理诊断为前列腺癌的患者与前列腺增生的患者的前列腺抗原及前列腺特异性抗原密度（PSAD）。结果327例患者中PSA在4～10ng/ml间者共112例,PSA在10～20ng/ml之间者共15例。术后病理诊断为前列腺癌的27例,其中有21例患者的PSAD值高于0.15。结论经尿道前列腺电切术（TURP）是早期发现前列腺癌的重要手段;前列腺特异性抗原密度（PSAD）有助于更好地鉴别前列腺增生症和前列腺癌。     

前列腺癌组织中溶卵磷酯酰基转移酶(LAT)增高:前列腺癌瘤标

过去曾有人报道前列腺癌组织中卵磷脂Ａ2 与溶卵磷酯酰基转移酶 (ＬＡＴ)活性增高。作者对大宗前列腺组织标本的ＬＡＴ活性进行检测分析 ,其中前列腺癌根治术标本 93例 ,膀胱癌根治术标本14例 ,良性前列腺增生行ＴＵＲＰ术标本5 5例 ,前列腺癌行姑息性ＴＵＲＰ术标本11例。在前列腺癌根治术标本中恶性肿瘤组织中ＬＡＴ活性高于良性前列腺组织 43% (Ｐ <0 .0 0 1)。 10例良性前列腺标本组织中ＬＡＴ活性明显低于前列腺癌根治术标本中良性组织ＬＡＴ的活性 (Ｐ <0 .0 5 )。膀胱全切术前列腺标本中ＬＡＴ活性明显高于良性前列腺增生ＴＵＲＰ术…     

同期行经尿道电切术治疗膀胱癌并前列腺增生的临床观察

目的：探讨膀胱癌并前列腺增生患者同期行经尿道膀胱肿瘤加前列腺电切术的可行性。方法：回顾性分析46例膀胱癌并前列腺增生患者的手术方法，26例同期行经尿道膀胱肿瘤加前列腺电切术（A组），20例单纯行经尿道膀胱肿瘤电切术（B组）。结果：随访12－40个月，A组有3例术后复发，复发时间为术后18．4个月，无尿道及前列腺窝转移；B组有4例术后复发，复发时间为术后15．4个月，5例随访期内因前列腺增生再次行经尿道前列腺电切术。结论：膀胱肿瘤并前列腺增生患者同期行经尿道电切术可减少经费，缩短住院时间。     

良性前列腺增生术后再发前列腺癌(附3例报告及文献复习)

目的探讨良性前列腺增生术后再发前列腺癌的机理及诊治措施。方法收集泰州市第三人民医院近10 a收治的3例良性前列腺增生术后再发前列腺癌患者的临床资料,进行回顾性分析。结果 2例接受经尿道前列腺电切术治疗的患者,分别于术后第4年、8年发现前列腺癌。1例行耻骨上经膀胱前列腺切除术治疗的患者,于术后第8年发现前列腺癌。2例行开放前列腺癌根治术,1例行机器人辅助腹腔镜下前列腺癌根治术。随访至今,3例患者均健在,未发现生化复发及骨转移。结论良性前列腺增生切除术不能预防前列腺癌。直肠指检、PSA检测、直肠超声前列腺穿刺活检是诊断良性前列腺增生术后再发前列腺癌的重要方法。重视对良性前列腺增生术后再发前列腺癌的认识,早期诊断和及时采用以前列腺根治术为主的综合疗法,可获理想的预后效果。     

前列腺、精囊

经尿道前列腺双极等离子电切术治疗前列腺增生症（附128例报告）；前列腺增生经尿道汽化电切时不同灌注方法的比较;经尿道前列腺气化并电切术治疗前列腺增生292例;良性前列腺增生伴糖尿病患者尿流动力学分析（附37例报告）;肿瘤标记物P504s在前列腺癌中的表达及应用价值;[编者按]     

同期行经尿道电切术治疗膀胱癌并前列腺增生的临床观察

目的:探讨膀胱癌并前列腺增生患者同期行经尿道膀胱癌加前列腺电切术的可行性。方法:回顾性分析28例膀胱癌并前列增生的手术方法,28例均同期行经尿道膀胱癌加前列腺电切术。结果:随12～30个月,有4例术后复发膀胱肿瘤,复发时间为术后16～28个月不等,平均18.6个月,无尿道及前列腺窝转移,未再次行尿道前列腺电切术病例。结论:膀胱肿瘤并前列腺增生患者同期行经尿道电切术可减少经费,缩短住院时间。     

前列腺、精囊

半导体激光治疗前列腺增生症420例；经尿道前列腺汽化电切术严重并发症及处理；前列腺癌根治术中保护控尿功能的技巧；前列腺增生术后发生前列腺癌12例报告；前列腺增生术后复发的相关因素探讨；手术治疗伴逼尿肌乏力的前列腺增生症；不同术式治疗前列腺增生症的疗效比较；CYP1A1与GSTM1基因多态性与前列腺癌易感性的关系；”^125Ⅰ放射粒子植入治疗激素难治性前列腺癌；前列腺恶性叶状肿瘤(附一例报告并文献复习)；碘仿纱腺窝填塞止血在耻骨上前列腺摘除术的临床研究；前列腺增生术后致后尿道狭窄20例临床分析。     

经尿道汽化电切与等离子电切治疗良性前列腺增生

目的:评价经尿道汽化电切与等离子电切治疗良性前列腺增生的疗效.方法:将良性前列腺增生患者76例,分成2组,36例行经尿道前列腺汽化电切(TUVP组)治疗,40例行经尿道前列腺等离子电切(TUPKP组)治疗.就手术时间、术中出血量、切除腺体重量、导尿管留置时间、并发症及术后1月最大尿流率等进行分析比较.结果:TUPKP组手术时间、术中出血量、导尿管留置时间明显低于TUVP组(P<0.05), TUVP组5例出现并发症.结论:TUPKP是一种理想的治疗前列腺增生方法,比TUVP更安全、有效.     

经尿道等离子体双极前列腺电切术后并发症的处理

我院自2005年5月—2007年4月开展经尿道等离子体双极汽化前列腺电切术（PKVP）治疗前列腺增生和前列腺癌146例，术后出现各种并发症48例，现分析如下。     

3T体线圈三维氢质子磁共振波谱在前列腺癌鉴别诊断中的价值

目的:探讨3T体线圈三维氢质子磁共振波谱(3D 1H-MRS)在前列腺癌鉴别诊断中的应用价值。方法:对40例临床可疑前列腺癌患者先行3T核磁共振(MRI)和磁共振波谱(MRS)检查,再行直肠B超引导下前列腺穿刺活检获得病理诊断。与病理结果对照,分析良性前列腺增生、前列腺癌、癌前病变MRS代谢特点,评估其对外周带前列腺癌的诊断效能。结果:所有患者均成功完成检查。间质、腺体增生为主内腺、内腺癌灶、外周带癌灶、正常外周带及前列腺上皮内瘤(胆碱+肌酸)/枸橼酸比值分别为:0.75±0.23、0.59±0.14、1.79±0.90、1.18±0.95、0.46±0.18、0.97±0.10。内腺癌灶与增生内腺、外周带癌灶与正常外周带差异有统计学意义(P<0.01)。外周带前列腺癌最佳诊断阈值为0.68,灵敏度88.6%,特异度88.7%。结论:3T体线圈3D 1H-MRS在前列腺癌鉴别诊断中具有较好的敏感性与特异性,对癌前病变的诊断有一定的参考价值。     

前列腺素合成酶2在前列腺癌和前列腺增生中的表达及其意义

目的研究前列腺素合成酶(COX)-2在前列腺癌和前列腺增生组织中的表达及与临床的关系.方法随机选择42份前列腺增生和16份前列腺癌患者的手术标本,从定性和定量两个方面分别采用免疫组织化学和蛋白印记方法对COX-2蛋白的表达进行研究.结果16份前列腺癌标本中,15份COX-2呈阳性表达,占93.8%;42份前列腺增生的组织中,只有11份有COX-2的表达,占26%,两者差异有非常显著意义(直接概率法P＜0.01).且COX-2高表达的前列腺癌患者预后不佳.结论COX-2在前列腺癌组织中表达增强,且与癌的临床分期有关.     

p53 antibodies in the serum of patients with prostate cancer

We assessed the potential clinical utility of levels of p53-specific antibodies as a novel serum biomarker of prostate cancer that could be used in conjunction with level of PSA. Material and methods Serum levels of p53-specific antibodies in patients with relapsed, newly diagnosed prostate cancer and in patients with benign prostate hyperplasia were quantified by an enzyme-linked immunoabsorbent assay. Result There was no significant difference (P = 0.96) between the serum levels of p53-specific antibodies in patients with newly diagnosed prostate cancer and with benign prostatic hyperplasia. In the newly diagnosed prostate cancer group, stage T1c (n = 8) showed the lowest p53-specific antibody level. However, the difference between T1c group and benign prostatic hyperplasia group was not significant (P = 0.686). The relapsed cancer group tended to have low levels of the antibodies, and, there was no significant difference between the relapsed prostate cancer group and the benign prostatic hyperplasia group (P = 0.14). The serum levels of p53-specific antibodies in patients with metastatic and with localized prostate cancer showed no significant difference (P = 0.68). Conclusion The use of titers of p53-specific antibodies to make differential diagnosis between prostate cancer and benign prostatic hyperplasia might have no role, and the antibodies should not be used as a marker of prostate cancer by itself. Because our study is based on small number of patients, further studies are necessary before its absolute validity can be determined.     

Immunohistochemical finding of α-1-antichymotrypsin in tissues of benign prostatic hyperplasia and prostate cancer

BACKGROUND: Ratio of free to total (F/T) prostate-specific antigen (PSA) is higher in the blood of patients with benign prostatic hyperplasia than those with prostate cancer. To clarify the difference between ratios in these two, alpha-1-antichymotrypsin, the major component of the bound PSA in the blood, was immunohistochemically examined. METHODS: Tissues were obtained surgically via a retropubic approach from patients with benign prostatic hyperplasia (nine cases) and prostate cancer (27 cases). These samples were processed in paraffin blocks, cut into 5 mm sections and stained with antibodies against alpha-1-antichymotrypsin and PSA. RESULTS: The percentage of alpha-1-antichymotrypsin-stained cells in prostate cancer was higher than that in benign prostatic hyperplasia (P<0.05). Almost all of glandular and cancer cells were stained with PSA antibody. The percentage of alpha-1-antichymotrypsin-stained cells in prostate cancer did not correlate to histologic grade, although alpha-1-antichymotrypsin-stained cells were more widely scattered in high grade tissues. No correlation was found between alpha-1-antichymotrypsin-stained cells and ratio of F/T in the blood of cancer patients. In about 20% of cancer tissues, histiocytes with positive alpha-1-antichymotrypsin staining were found in stroma but not in that of benign prostatic hyperplasia. CONCLUSIONS: Prostate cancer tissues are shown to have a richer environment of alpha-1-antichymotrypsin than those of benign prostatic hyperplasia. Some cancer tissues contained alpha-1-antichymotrypsin-stained histiocytes. These local events may correlate to a high amount of the bound form among total PSA in the blood of prostate cancer patients.     

Lack of value of radioimmunoassay for prostatic acid phosphatase as a screening test for prostatic cancer in patients with obstructive prostatic hyperplasia

We examined the incidence of prostatic cancer in patients with an elevated radioimmunoassay for prostatic acid phosphatase and clinical benign prostatic hyperplasia on digital rectal examination. Of 295 patients screened with prostatic acid phosphatase tests 17 fulfilled the criteria of having an elevated prostatic acid phosphatase, clinically benign prostate and histological examination of the prostatectomy specimen. None of the 17 patients had histological evidence of prostatic cancer. The results confirm the predictions of mathematical models that prostatic acid phosphatase is of no practical value as a screening test for prostatic cancer in patients with clinical benign prostatic hyperplasia.     

Angiogenesis imaging in the management of prostate cancer

Angiogenesis is an integral part of benign prostatic hyperplasia, is associated with prostatic intraepithelial neoplasia and is a key factor in the growth and metastasis of prostate cancer. This review focuses on ultrasound and dynamic MRI in the evaluation of prostate cancer angiogenesis, and compares these techniques to functional CT and hydrogen magnetic resonance spectroscopic imaging. Image-based evaluation of angiogenesis in the prostate has established clinical roles in lesion detection, tumor staging and the detection of suspected tumor recurrence. One limitation of all these imaging techniques, however, is inadequate lesion characterization, particularly in differentiating prostatitis from cancer in the peripheral zone of the prostate, and in distinguishing between benign prostatic hyperplasia and central-gland tumors. Ultimately, local availability, expertise and the need to minimize patients' radiation burden will influence which technique is used in prostatic evaluations.     

Fluorine-18-fluorodeoxyglucose positron emission tomography is useless for the detection of local recurrence after radical prostatectomy.

OBJECTIVE: After radical retropubic prostatectomy a rise of the prostate-specific antigen (PSA) indicates a local recurrent or metastatic disease. If the bone scan shows no apparent bone metastasis, morphological imaging methods like x-ray computed tomography, magnetic resonance imaging or transrectal ultrasound often cannot distinguish between postoperative scar and local recurrence. Therefore we investigated the feasibility of fluorine-18-fluorodeoxyglucose positron emission tomography (F-18 FDG PET) for metabolic characterization of prostatic cancer, especially for differentiation of scar or recurrent prostate cancer after radical prostatectomy. METHODS: Dynamic PET with 370 MBq F-18 deoxyglucose (F-18 FDG) up to 60 min p.i. was performed in 2 patients with biopsy-proven benign prostatic hyperplasia, in 11 patients with a histologically proven prostate cancer prior to radical retropubic prostatectomy (RRP) and 7 patients with suspected local recurrence (with negative bone scan) after RRP prior to biopsy of anastomosis (3 local recurrence, 4 postoperative scar). RESULTS: Prostate cancer showed a very low F-18 FDG uptake. The placement of regions of interest was only possible by the use of other imaging methods. There was not difference between the F-18 FDG uptake of benign prostate hyperplasia, prostate carcinoma, postoperative scar or local recurrence after radical prostatectomy. CONCLUSION: F-18 FDG seems not to be useful to distinguish between postoperative scar and local recurrence after radical prostatectomy.     

Characterization of prostate cancer, benign prostatic hyperplasia and normal prostates using transrectal 31phosphorus magnetic resonance spectroscopy: a preliminary report.

We assessed the ability of 31phosphorus (31P) transrectal magnetic resonance spectroscopy to characterize normal human prostates as well as prostates with benign and malignant neoplasms. With a transrectal probe that we devised for surface coil spectroscopy we studied 15 individuals with normal (5), benign hyperplastic (4) and malignant (6) prostates. Digital rectal examination, transrectal ultrasonography and magnetic resonance imaging were used to aid in accurate positioning of the transrectal probe against the region of interest within the prostate. The major findings of the in vivo studies were that normal prostates had phosphocreatine-to-adenosine triphosphate (ATP) ratios of 1.2 +/- 0.2, phosphomonoester-to-beta-ATP ratios of 1.1 +/- 0.1 and phosphomonoester-to-phosphocreatine ratios of 0.9 +/- 0.1. Malignant prostates had phosphocreatine-to-beta-ATP ratios that were lower (0.7 +/- 0.1) than those of normal prostates (p less than 0.02) or prostates with benign hyperplasia (1.1 +/- 0.2, p less than 0.01). Malignant prostates had phosphomonoester-to-beta-ATP ratios (1.8 +/- 0.2) that were higher than that of normal prostates (p less than 0.02). Using the phosphomonoester-to-phosphocreatine ratio, it was possible to differentiate metabolically malignant (2.7 +/- 0.3) from normal prostates (p less than 0.001), with no overlap of individual ratios. The mean phosphomonoester-to-phosphocreatine ratio (1.5 +/- 0.5) of prostates with benign hyperplasia was midway between the normal and malignant ratios, and there was overlap between individual phosphomonoester-to-phosphocreatine ratios of benign prostatic hyperplasia glands with that of normal and malignant glands. To verify the in vivo results, we performed high resolution magnetic resonance spectroscopy on perchloric acid extracts of benign prostatic hyperplasia tissue obtained at operation and on a human prostatic cancer cell line DU145. The extract results confirmed the differences in metabolite ratios observed in vivo. We conclude that transrectal 31P magnetic resonance spectroscopy can characterize metabolic differences between the normal and malignant prostate.     

PEDF在前列腺癌患者血清中的表达及临床意义

目的：探讨色素上皮衍生因子（pigmentary epithelium derived factor,PEDF）在前列腺癌患者血清中表达并探讨其临床意义。方法：应用免疫印迹（Western blotting）法检测前列腺癌转移（PCaM）患者、前列腺癌未转移（PCa）患者及良性前列腺增生（BPH）患者血清中PEDF表达情况,并通过统计学方法比较各组PEDF的表达差异。结果：PEDF在BPH组血清样本中高于PCa组（P〈0．05）。PEDF在PCa组的血清样本中也高于PCaM组（P〈0．05）。结论：PEDF与前列腺癌的发牛和转移相关,并可能在前列腺癌的进展中起重要作用,借助测定PEDF的表达可以协助前列腺癌的诊断和预后评估。     

Circadian and day-to-day variation of prostatic acid phosphatase

The circadian and day-to-day variation of serum levels of prostatic acid phosphatase determined by radioimmunoassay was investigated in 10 men with a normal prostate, 8 with benign prostatic hyperplasia and 10 with prostate cancer. Serum samples were obtained on 1 day at 8 a.m., 12:00 noon and 4:30 pm. in 23 patients, and on 3 consecutive days at 8 a.m. in an additional 5 patients. There was a variability in enzyme level throughout the day but without any distinct pattern. Prostate cancer patients with elevated levels of prostatic acid phosphatase did demonstrate a greater variability throughout the day than patients with a normal prostate or with benign prostatic hyperplasia. The day-to-day serum prostatic acid phosphatase in patients with a normal prostate varied little and remained within the normal range.