Ishizu K, Konishi M, Joko K, Takihara H, Sakatoku J, Tanaka K
Department of Urology, Nagato General Hospital.
Hinyokika Kiyo. 1992 Mar;38(3):343-6.
A 76-year-old man complained of initial hematuria and dysuria. Right lobe of the prostate was elastic soft, enlarged and hypoechoic. The serum levels of PA and gamma-Sm were abnormally high. Prostatic biopsy showed papillary adenocarcinoma which was stained by prostatic specific antigen (PA). The cancer was clinically diagnosed as stage C. Antiandrogen therapy was performed. After three months, the prostatic tumor markers decreased to the normal range and the tumor reduced in size without any findings of metastasis on CT scan. Because prostatic biopsy showed viable cancer cells, radiotherapy was added. After six months, the tumor reduced in size without any signs of metastasis on CT scan and prostatic biopsy revealed no viable cancer cells or elevation of the tumor markers. The positive staining for PA and the good response to antiandrogen therapy in our case support the view that papillary adenocarcinoma of the prostate is only a morphologic variant of ordinary prostatic carcinoma (acinous adenocarcinoma).
一名76岁男性主诉初始血尿和排尿困难。前列腺右叶质地弹性柔软，增大且呈低回声。血清PA和γ-Sm水平异常升高。前列腺活检显示为乳头状腺癌，经前列腺特异性抗原（PA）染色。该癌症临床诊断为C期。进行了抗雄激素治疗。三个月后，前列腺肿瘤标志物降至正常范围，肿瘤体积缩小，CT扫描未发现转移迹象。由于前列腺活检显示有存活的癌细胞，因此增加了放疗。六个月后，肿瘤体积缩小，CT扫描未发现转移迹象，前列腺活检未发现存活的癌细胞，肿瘤标志物也未升高。我们病例中PA的阳性染色以及对抗雄激素治疗的良好反应支持了前列腺乳头状腺癌只是普通前列腺癌（腺泡腺癌）的一种形态学变体这一观点。
