前列腺小细胞癌(附一例报告并文献复习).pdfVIP

老年医学与保健 2007 年第 13 卷第 3 期 Geriatr Health Care, 2007,Vol.13.No.3 前列腺小细胞癌（附一例报告并文献复习） 钱伟庆　孙忠全　徐　俊　吴惠兴　谢旦生　盛　璐　丁海雍　汪东亚　张豪杰　宋建达 【摘要】　目的　提高对前列腺小细胞癌的认识，探讨其诊治方法。 方法　分析 2005 年 4 月收治的 1 例前列腺小 细胞癌患者的临床资料，并进行文献复习。患者 65 岁，因尿急 1 月，直肠指诊前列腺右叶突起明显，质地硬入院。血 PSA1.92 ng/ml。MRI：前列腺右侧肿块侵犯右侧膀胱精囊三角，并与直肠前壁相连。前列腺穿刺病理示：小细胞癌。 行手术去势和前列腺与盆腔区域放疗。治疗失败后行 EP 方案化疗。结果　内分泌治疗无效，2 月后病情进展，广泛转 移，患者骨痛，吞咽困难，血肿瘤标志物如 NSE 等升高。化疗有效，患者症状明显改善，血肿瘤标志物水平下降，可 测量病灶稳定。化疗 5 疗程后病情进展，2006 年 3 月 18 日死亡。 结论　前列腺小细胞癌预后差，内分泌治疗无效，化 疗在治疗中占有重要地位。 【关键词】　前列腺肿瘤；　癌，小细胞；　抗肿瘤联合化疗方案 [ 中图分类号 ] R737.25 [ 文献标识码 ] A [ 文章编号 ] 1008-8296(2007)-03-0150-03 Small cell carcinoma of prostate：a case report and review of the literature QIAN Wei-qing, SUN Zhong-quan, XU Jun, WU Hui-xing, XIE Dan-sheng, SHENG Lu, DING Hai-yong, WANG Dong-ya, ZHANG Hao-jie, SONG Jian-da Department of Urology, Huadong Hospital, Fudan University, Sha nghai 200040, China 【Abstract】　Objective　To study the diagnosis and treatment of small cell carcinoma of prostate. Methods　A 65-year-old patient with pure small cell carcinoma of prostate was admitted because of complaints of urinary urgency for 1 month. DRE revealed enlarged prostates and hard consistency of the right lobe. Serum PSA level was 1.92ng/ml. MRI showed that the tumor in the right lobe of prostate involved the encroachment bladder, right seminal vesicle and rectum. Findings of histological biopsy were consistent with a diagnosis of small cell carcinoma of prostate. The patient failed to respond to endocrine therapy and radiotherapy, so that combination chemotherapy with EP regimen was used. Results　Two months after failing endocrine therapy, the disease progressed with multiple metastases. The patient felt ostealgia and dysphagia. Serum markers for neoplasia including N