论文部分内容阅读
目的:探讨原发性精囊腺癌的病理学特点和诊疗方法。方法:分析4例原发性精囊腺癌的临床资料和病理学特征,并行全面文献复习。结果:4例患者均行开放性前列腺根治性切除术,病理确诊为原发性精囊腺癌:1例术前行前列腺穿刺活检阴性,行开放前列腺癌根治术后确诊为精囊腺癌:1例术前经CT及经直肠超声可见盆腔巨大囊性多分隔肿物,术中冰冻病理诊断为精囊腺癌,转行开放性前列腺根治术。2例术前血清PSA水平数值分别为20.15、40.75μg/ml,余2例水平正常,4例术后血清PSA水平均正常。4例患者免疫组化结果提示PSA、PAP和CK20均阴性,而CA125和CK7阳性。4例术后恢复良好,分别随访154、41、20、12个月,未见复发转移。结论:原发性精囊腺癌极其罕见,临床发现较晚。免疫组化对鉴别诊断价值很大。目前提倡多种方法诸如根治手术、放疗、雄激素剥夺疗法和化疗的综合治疗。
Objective: To investigate the pathological features and diagnosis and treatment of primary seminal vesicle adenocarcinoma. Methods: The clinical data and pathological features of 4 cases of primary seminal vesicle adenocarcinoma were analyzed and reviewed comprehensively. Results: All the 4 patients underwent open radical prostatectomy and the pathology was diagnosed as primary seminal vesicle adenocarcinoma: one case had negative prostatic biopsy and one case of seminal vesicle adenocarcinoma after radical prostatectomy Preoperative CT and transrectal ultrasound can be seen in the pelvic giant cystic mass separation, intraoperative frozen pathology diagnosis of seminal vesicle adenocarcinoma, switch to open radical prostatectomy. Two cases of preoperative serum PSA levels were 20.15,40.75μg / ml, the remaining two cases were normal, four postoperative serum PSA levels were normal. Immunohistochemical results of 4 patients suggested that PSA, PAP and CK20 were negative, while CA125 and CK7 were positive. 4 cases recovered well, were followed up 154,41,20,12 months, no recurrence and metastasis. Conclusion: Primary seminal vesicle adenocarcinoma is extremely rare, and clinical findings are late. Immunohistochemical diagnosis of great value. Various methods are currently advocated such as radical surgery, radiotherapy, androgen deprivation therapy and chemotherapy combined treatment.