摘要
目的探讨前列腺上皮内瘤(prostatic intraepithelial neoplasm,PIN)的临床诊断和治疗。方法分析37例PIN患者的临床资料。良性前列腺增生合并PIN24例,其中高级别PIN(high grade PIN,HGPIN)8例,低级别PIN(low grade PIN,LGPIN)16例,行TURP手术22例,耻骨上经膀胱前列腺摘除术2例;前列腺癌并发PIN 7例(均为HGPIN),行前列腺根治性切除术5例,2例行雄激素全阻断治疗;其余病例为单纯HGPIN 4例,LGPIN 2例。结果 24例前列腺增生合并PIN患者随访1～6年,22例健康存活,2例HGPIN因年龄>75岁,6个月后重复前列腺穿刺为HGPIN,复查PSA>10ng/L行雄激素全阻断治疗,至今仍健康存活。7例前列腺癌并发HG-PIN者随访1～5年,6例均健康存活,1例5年后死亡。2例单纯HGPIN重复前列腺穿刺活检发现前列腺癌行前列腺根治性切除术,随访2～5年均健康存活。另2例单纯HGPIN及2例单纯LG-PIN予临床密切观察,随访2～6年均健康存活。结论病理检查是诊断PIN的唯一方法,HG-PIN是前列腺癌的癌前病变,应给予严密随访,必要时采取积极的治疗措施。
Objective To investigate the diagnosis and treatments of prostatic intraepithelial neoplasm（PIN）.Methods The clinical data of 37 cases of PIN were analyzed.8 cases of high grade PIN（HGPIN） and 16 cases of low grade PIN（LGPIN） were found in 24 BPH patients tissues.TURP was performed in 22 cases and suprapubic prostatectomy in 2 cases;7 cases of HGPIN were diagnosed with prostate carcinoma,of whom 5 underwent radical prostatectomy and 2 underwent the maxism blocking.Others were 4 cases of HGPIN and 2 cases of LGPIN.Results The 22 BPH patients with PIN were free of disease after 1 to 6 years follow up,the other 2 cases were survived after undergoing the maxism androgen blocking,because of age were larger than 75 years and serum PSA were higher than 10 ng/L.Of the 7 cases of prostate carcinoma with HGPIN,6 survived during follow up for 1 to 5 years;1 died after five years.2 cases of HGPIN were found through biopsies of the prostate and had radical prostatectomy.They were survived after 2 to 5 years follow up.2 cases of HGPIN and 2 cases of LGPIN were free of disease after 2 to 6 years close clinical follow up.Conclusions Pathology is the only way for diagnosis of PIN.HGPIN is a precancerous change of prostatic carcinoma and regular close follow up are suggested.Treatments should aim directly at HGPIN when necessary.
出处
《现代泌尿生殖肿瘤杂志》
2011年第4期216-218,共3页
Journal of Contemporary Urologic and Reproductive Oncology
关键词
前列腺上皮内瘤病
诊断
治疗
Prostatic intraepithelial neoplasia
Diagnosis
Therapy
