摘要
目的:探讨前列腺肉瘤的诊断、治疗及预后。方法:回顾性分析1992年3月～2010年1月收治的8例前列腺肉瘤患者的临床资料,就其诊治及预后进行研讨。结果:8例患者中,横纹肌肉瘤2例、平滑肌肉瘤2例及粒细胞肉瘤、恶性间叶瘤、叶状囊肉瘤各1例,1例穿刺为间叶源性恶性肿瘤,未进一步分类。4例行根治性前列腺切除术,3例术后未行辅助治疗,分别于术后16、10、8个月死于远处转移,另1例失访;1例行根治性膀胱切除术,术后辅以规律化疗,无瘤存活至今16个月;3例未行手术治疗,依靠穿刺确诊,1例行辅助化疗后存活4个月,死于远处转移,其余2例未行辅助治疗,分别于确诊后4、5个月死于全身转移。结论:前列腺肉瘤首发症状大多为进行性排尿困难,PSA及DRE检查不能确诊前列腺肉瘤,术前需依靠磁共振成像、经直肠超声及前列腺穿刺活检共同确诊,免疫组化染色有助于其分类。该病预后差,治疗以根治性前列腺切除术为主,术后联合放、化疗等辅助治疗可提高患者生存率。
Objective： To investigate the diagnosis, treatment and prognosis of prostate sarcoma. Methods： The clinical date of 8 cases of prostate sarcoma were retrospectively reviewed in our hospital between March 1992 and January 2010, and to explore the diagnosis, treatment and prognosis with literature review. Results：Of the 8 cases,2 was rhabdomyosar- coma, 2 was leiomyosarcoma and 1 was granulocytic sarcoma, malignant mesenchymoma and eystosarcoma phylloides re- spectively. 1 was mesenchymal tumor by biopsy,but not further classified. Four patients were treated by radical prostatectomy, three of which died of metastases 16,10,8 respectively months after the operation without adjuvant therapy,and the other case lost; One patient was treated by radical cystectomy,supplemented by regular postoperative chemotherapy,and survived 16 months without tumor; The diagnosis of three patients were established to rely on prostate biopsy, one of which died of metastases 4 months after the diagnosis with adjuvant chemotherapy,two of which died of metastases 4,5 respectively months after the diagnosis without adjuvant therapy. Conclusions：Dysuria is always the first symptom of pros- tate sarcoma. DRE and PSA barely suggeste prostate sarcoma, therefore MRI,Transrectal Color Doppler Ultrasound and the needle biopsy contributes to a definite diagnosis. The immuno-histochemical dyeing helps to differentiate the disease. The prognosis of prostate sarcoma is very poor and the main treatment is radical surgery followed by radiotherapy and/or chemotherapy etc that may increase the survival rate.
出处
《临床泌尿外科杂志》
北大核心
2011年第10期769-771,共3页
Journal of Clinical Urology
关键词
前列腺肿瘤
肉瘤
诊断
治疗
预后
prostate neoplasms
sarcoma
diagnosis
treatment
prognosis
