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膀胱移行细胞癌合并前列腺癌的诊断与治疗:附5例报告

[Diagnosis and treatment of coincident vesical transitional cell carcinoma and prostate cancer: a report of 5 cases].

作者信息

Song Yong-Sheng, Song Yan, Luo Jin-Yu, Wu Bin

机构信息

Department of Urology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110004, China.

出版信息

Zhonghua Nan Ke Xue. 2010 Jan;16(1):44-7.

Abstract

OBJECTIVE

To improve the diagnosis and treatment of coincident vesical transitional cell carcinoma (VTCC) and prostate cancer.

METHODS

We analyzed the clinical data of 5 cases of coincident VTCC and prostate cancer.

RESULTS

The 5 patients, at the mean age of 66.2 years, were diagnosed as having grade II - III VTCC by cystoscopy and biopsy, 1 with a history of prostate cancer, and the other 4 with prostate cancer confirmed by postoperative pathological examination. Two of the patients were treated by radical cystoprostatectomy, 1 by radical cystoprostatectomy and ileum conduit surgery, 1 by transurethral resection of bladder tumor, and the other 1 by palliative ureterocutaneostomy due to cardiopulmonary problems. The follow-up lasted 8 -26 months. One of them died of diffused metastasis 20 months after surgery, 1 survived with the tumor untreated, and the other 3 remained tumor free.

CONCLUSION

Coincident VTCC and prostate cancer is easy to be missed in diagnosis. PSA detection, rectal palpation, transrectal ultrasonography, biopsy, and cystoscopy are the main diagnostic options for this disease. Its treatment should be based on the classification and clinical staging of the two cancers. Coincident VTCC and prostate cancer does not suggest poor prognosis.

摘要

目的

提高膀胱移行细胞癌(VTCC)合并前列腺癌的诊断与治疗水平。

方法

分析5例VTCC合并前列腺癌患者的临床资料。

结果

5例患者平均年龄66.2岁,经膀胱镜检查及活检确诊为Ⅱ - Ⅲ级VTCC,其中1例有前列腺癌病史,另外4例经术后病理检查确诊为前列腺癌。2例患者接受了根治性膀胱前列腺切除术,1例接受了根治性膀胱前列腺切除术及回肠膀胱术,1例接受了经尿道膀胱肿瘤切除术,另1例因心肺问题接受了姑息性输尿管皮肤造口术。随访时间为8 - 26个月。其中1例术后20个月死于广泛转移,1例带瘤生存,另外3例无瘤生存。

结论

VTCC合并前列腺癌在诊断时易被漏诊。PSA检测、直肠指诊、经直肠超声检查、活检及膀胱镜检查是该病的主要诊断方法。其治疗应根据两种癌症的分级及临床分期而定。VTCC合并前列腺癌并不意味着预后不良。

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