正常血清PSA进展期前列腺癌1例报告并文献复习

目的:探讨正常血清PSA进展期前列腺癌患者的诊断及治疗方法,提高前列腺癌的诊疗水平。方法:回顾性分析2010年收治的1例正常血清PSA进展期前列腺癌患者临床资料,结合相关文献,讨论正常血清PSA进展期前列腺癌的诊断及治疗方法。结果:患者血清PSA水平一直处于正常水平,经病理学检查证实为前列腺癌,临床分期为T4N0M0,行前列腺去势术+抗雄激素治疗,现已无进展生存15个月。结论:正常血清PSA进展期前列腺癌多系特殊病理类型的前列腺癌,预后相对较差。在进行PSA筛查时,需综合考虑f/tPSA比值;术后随诊时需定期进行影像学检查,以了解有无疾病进展;治疗上除采取内分泌治疗外,必要时宜早期采用放疗及化疗。

One case of progressive prostate cancer with normal serum prostate-specific antigen and literature review

Objective:To discuss the diagnosis and treatment of progressive prostate cancer with normal serum prostate-specific antigen(PSA).Methods:One case of progressive prostate cancer with normal serum PSA in our hospital in 2010 was analyzed.The diagnosis and treatment of progressive prostate cancer with normal PSA was discussed as well as correlative literature reviwed.Results:The patient with normal serum PSA was diagnosed prostate cancer by pathology,and the clinical stage was T4N0M0.The patient was living for 15 month by castration plus anti-androgen therapy.Conclusions:The pathology type of normal serum PSA progressive prostate are always special types including undifferentiated carcinoma and the prognosis are relatively bad.The f/tPSA ratio should be considered when screening prostate cancer by PSA and imaging examinations such as MRI should be used for follow-up.Active chemotherapy and irradiation therapy should be use except by castration and hormone therapy.