Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of First Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China.
Am J Mens Health. 2022 Mar-Apr;16(2):15579883221087839. doi: 10.1177/15579883221087839.
The purpose of the study was to retrospectively summarize the diagnosis and management of 10 primary prostatic signet ring cell carcinoma (PPSRCC) cases in our center. Ten PPSRCC patients diagnosed at the First Affiliated Hospital of Nanjing Medical University from November 2014 to December 2020 were included. Clinical characteristics, image features, therapeutic procedures, histological diagnosis, and outcomes were retrospectively analyzed. All patients received prostate-specific antigen (PSA) examination preoperatively. Nine of them accepted multiparametric magnetic resonance imaging (mpMRI) due to elevated PSA value, and further biopsied. Among them, five patients were diagnosed as prostatic adenocarcinoma and the other four cases were found a mixture of signet ring cell carcinoma (SRCC) and adenocarcinoma. Furthermore, gastrointestinal endoscope and abdominal computed tomography (CT) did not find SRCC originating in gastrointestinal tract. Therefore, these cases were considered to be PPSRCC. Nine patients accepted laparoscopic or robot-assisted RP. Only one patient with normal PSA adopted transurethral resection of the prostate. Postoperative pathological results confirmed SRCC mixed with prostatic adenocarcinoma in nine cases, and only one patient with pure SRCC. After surgery, nine patients received adjuvant hormone therapy, one of which accepted radiotherapy simultaneously. The patient with pure SRCC did not accept any adjuvant therapy postoperatively. During a mean follow-up of 31.9 months, only four patients were alive without disease progression. In summary, PPSRCC is a rare malignant tumor with few specific symptoms, rapid disease progression, and poor prognosis and is frequently accompanied by high-grade prostate adenocarcinoma patterns. There is still no clear and effective strategy to improve the prognosis.
本研究旨在回顾性总结本中心 10 例原发性前列腺印戒细胞癌（PPSRCC）的诊断和治疗。纳入 2014 年 11 月至 2020 年 12 月在南京医科大学第一附属医院诊断的 10 例 PPSRCC 患者。回顾性分析了患者的临床特征、影像学特征、治疗方案、组织学诊断和结局。所有患者术前均接受前列腺特异性抗原（PSA）检查。9 例因 PSA 值升高接受多参数磁共振成像（mpMRI）检查，进一步行前列腺穿刺活检。其中 5 例诊断为前列腺腺癌，另 4 例发现为印戒细胞癌（SRCC）和腺癌的混合癌。此外，胃肠镜和腹部 CT 未发现来源于胃肠道的 SRCC，因此考虑为 PPSRCC。9 例患者接受了腹腔镜或机器人辅助前列腺根治术。仅 1 例 PSA 正常的患者接受了经尿道前列腺切除术。术后病理结果证实 9 例为 SRCC 混合前列腺腺癌，仅 1 例为纯 SRCC。术后 9 例患者接受辅助激素治疗，其中 1 例同时接受放疗。1 例纯 SRCC 患者术后未接受任何辅助治疗。在平均 31.9 个月的随访中，仅 4 例患者无疾病进展存活。综上所述，PPSRCC 是一种罕见的恶性肿瘤，症状不特异，疾病进展迅速，预后差，常伴有高级别前列腺腺癌形态。目前仍没有明确有效的策略来改善预后。
