穿刺活检未证实为前列腺癌的血清前列腺特异性抗原阳性的原发部位不明的肿瘤一例报道并文献复习

发布时间：2018-08-12 15:09

【摘要】：目的提高对血清前列腺特异性抗原(PSA)显著升高但穿刺活检未证实为前列腺癌的PSA+的原发部位不明的肿瘤(CUP)的认识。方法报道荆州市中心医院1例血清PSA显著升高但穿刺活检未证实为前列腺癌的PSA+的CUP的诊疗过程,并进行文献复习。在万方数据知识服务平台及Pub Med中检索,时间截至2016-10-09,共8篇文献入选,加上本例患者,共10例血清PSA显著升高但穿刺活检未证实为前列腺癌的PSA+患者被报道,对其进行分析总结。结果 10例男性患者中,年龄61~80岁;直肠指诊均为阴性(前列腺中等大小,质软,未扪及明显结节);血清PSA 56.3~4 222.0μg/L;均发现骨转移灶或盆腔淋巴结转移灶,经反复前列腺穿刺活检未能证实为前列腺癌,而诊断为PSA+的CUP;均采用姑息性内分泌治疗。结论血清PSA显著升高,但前列腺穿刺活检结果为阴性的PSA+的CUP患者临床上可考虑采取姑息性内分泌治疗策略,以期延缓患者疾病的进展或缓解患者症状,提高生存质量。
[Abstract]:Objective to improve the recognition of (CUP) in PSA with elevated serum prostate specific antigen (PSA) but not confirmed by biopsy. Methods the diagnosis and treatment of CUP in a patient with PSA whose serum PSA was significantly elevated but not confirmed by puncture biopsy in Jingzhou Central Hospital were reported and the literature was reviewed. A total of 8 articles were selected from Wanfang data knowledge Service platform and Pub Med, and 10 PSA patients whose serum PSA was significantly increased but not confirmed by biopsy were reported. It is analyzed and summarized. Results among the 10 male patients, the age was 61 ~ 80 years, the rectal finger diagnosis was negative (the prostate was medium size, soft, not palpable nodule), the serum PSA was 56. 3% 4 222.0 渭 g / L, bone metastasis or pelvic lymph node metastasis was found. Repeated prostate biopsy was not proved to be prostate cancer, but was diagnosed as PSA. All patients were treated with palliative endocrine therapy. Conclusion Serum PSA is significantly increased, but CUP patients with negative prostate biopsy results may consider palliative endocrine therapy in order to delay the progress of the disease, alleviate the symptoms and improve the quality of life.
【作者单位】：荆州市中心医院长江大学第二临床医学院华中科技大学同济医学院附属荆州医院泌尿外科;
【分类号】：R737.25

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