摘要
目的 探讨前列腺上皮内瘤 (PIN)的临床特征、诊断和处理。 方法 分析 13例PIN患者的临床资料。良性前列腺增生合并PIN 4例 (HGPIN 1例 ,LGPIN 3例 ) ,行TURP手术 3例 ,耻骨上经膀胱前列腺摘除术 1例 ;前列腺癌并发PIN 8例 (均为HGPIN) ,行前列腺根治性切除术 5例 ,TURP手术 3例 ;体检发现LGPIN 1例 ,因血PSA持续升高 ,TURP术后给予雄激素全阻断治疗。 结果 13例均经病理确诊 ,血PSA检测、直肠指诊和经直肠B超等检查对PIN诊断无意义。 4例BPH合并PIN患者均健康存活 (3～ 5年 ) ,1例 1年后随访活检发现进展为前列腺癌 ,行前列腺根治性切除术 ;5例前列腺癌并发PIN患者随访 2～ 5年后健康存活 ,1例死于其它疾病 ,2例失访 ;体检发现者 3个月后血PSA明显下降。 结论 病理检查是诊断PIN的惟一方法。对PIN应进行雄激素全阻断治疗并密切随访 ,定期穿刺活检是早期发现PIN恶变的有效方法。
Objective To investigate the clinical features,diagnosis and management of prostatic intraepithelial neoplasm (PIN). Methods The clinical data of 13 cases of PIN were analyzed.One case of high grade PIN (HGPIN) and 3 of low grade PIN (LGPIN) were found in 4 benign prostatic hyperplasia patients.TURP was performed in 3 cases and suprapubic prostatectomy in 1 case;8 cases of HGPIN were diagnosed with prostate carcinoma,of whom 5 underwent radical prostatectomy and 3,TURP;1 case of LGPIN was detected by health examination and the total blocking of androgen after TURP was performed on him due to the continuous elevation of serum PSA. Results All cases were finally diagnosed by pathology;while serum PSA,digital examination of rectum and trans-rectum B-ultrasound were of no significance.The 4 BPH patients with PIN were fine after 3- to 5-year follow-up,1 of them developed prostate carcinoma 1 year later and had radical prostatectomy.Of the 8 cases of prostate carcinoma with PIN,5 survived during follow-up for 2 to 5 years;1 died of other disease, and 2 were lost.The serum PSA level of the case found by health examination decreased markedly 3 months after the total blocking of androgen. Conclusions Pathology is the only way for diagnosis of PIN.The total blocking of androgen and close follow-up should be performed for PIN patients,and the best means to early detect the canceration of this disease is regular needle biopsy.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2004年第12期813-815,共3页
Chinese Journal of Urology
