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目的探讨前列腺间质肿瘤的临床特点及诊断策略。方法收集2例前列腺间质肿瘤的病例并且回顾了相关评估此疾病临床特点及早期诊断策略的文献。1例是1位老年患者因排尿困难而至泌尿外科就诊,另1例老年患者是因排便困难而至普通外科就诊。2例患者的直肠指检结果表明前列腺的体积增大并有硬结,但是前列腺特异性抗原(PSA)却未明显升高。前列腺穿刺活检结果表明硬结中有大量的梭形细胞,免疫组化结果显示CD117(+),CD34(+),SMA(-),病理诊断为前列腺间质肿瘤。结果这2例报告说明前列腺间质肿瘤的临床特点主要是排尿困难,排便困难,经直肠前列腺超声检查发现前列腺体积增大并伴随着PSA的轻度升高或处于正常水平。前列腺穿刺活检在早期诊断前列腺间质肿瘤中发挥着极其重要的作用。结论对于前列腺有肿块并且PSA水平正常的患者,有必要进行进一步的检查。
Objective To investigate the clinical features and diagnostic strategies of prostate stromal tumors. Methods Two cases of prostate stromal tumors were collected and the related literature to evaluate the clinical features and early diagnosis of the disease was reviewed. One patient was admitted to a urology department due to dysuria in one elderly patient, and the other one was referred to a general surgery department because of difficulty in defecation. The digital rectal examination results of 2 patients showed that the prostate volume increased and had induration, but the prostate specific antigen (PSA) did not increase significantly. Prostate biopsies showed a large number of spindle cells in the induration, and immunohistochemistry showed CD117 (+), CD34 (+) and SMA (-), and pathological diagnosis of prostate stromal tumors. Results These two reports showed that the main clinical features of prostate stromal tumors were dysuria and dyspareunia. Prostate enlargement accompanied with mild or normal PSA level was found in transrectal ultrasound. Prostate biopsy plays an important role in the early diagnosis of prostate stromal tumors. Conclusions For patients with lumps of prostate and normal PSA levels, further examination is warranted.