Weng Xiang-Tao, Lin Wen-Li, Pan Qi-Man, Chen Tao-Fen, Li Si-Yi, Gu Chi-Ming
Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China.
Department of Urology, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China.
World J Clin Cases. 2023 Sep 16;11(26):6213-6222. doi: 10.12998/wjcc.v11.i26.6213.
Aggressive variant prostate cancer (AVPC) is a rare disease that progresses rapidly. The first-line treatment for AVPC is currently unknown. We examined a rare case of AVPC with rare brain and bladder metastases. A summary review of the mechanism of development, clinicopathological manifestations, associated treatments and prognosis of this disease is presented.
The patient was diagnosed with prostate cancer (PCA), and was actively treated with endocrine therapy, radiotherapy, chemotherapy, and traditional Chinese medicine. Unfortunately, he was insensitive to treatment, and the disease progressed rapidly. He died five years after being diagnosed with PCA.
We should reach consensus definitions of the AVPC and other androgen receptor-independent subtypes of PCA and develop new biomarkers to identify groups of high-risk variants. It is crucial to complete a puncture biopsy of the tumor or metastatic lesion as soon as possible in patients with advanced PCA who exhibit clinical features such as low Prostate-specific antigen levels, high carcinoembryonic antigen levels, and insensitivity to hormones to determine the pathological histological type and to create a more aggressive monitoring and treatment regimens.
侵袭性变异型前列腺癌（AVPC）是一种罕见且进展迅速的疾病。目前，AVPC的一线治疗方法尚不明确。我们研究了一例罕见的伴有脑和膀胱转移的AVPC病例，并对该疾病的发生机制、临床病理表现、相关治疗及预后进行了简要综述。
该患者被诊断为前列腺癌（PCA），并接受了内分泌治疗、放疗、化疗及中药等积极治疗。遗憾的是，他对治疗不敏感，疾病进展迅速。在被诊断为PCA五年后死亡。
我们应就AVPC及PCA的其他雄激素受体非依赖性亚型达成共识定义，并开发新的生物标志物以识别高危变异组。对于出现前列腺特异性抗原水平低、癌胚抗原水平高及激素不敏感等临床特征的晚期PCA患者，尽快完成肿瘤或转移灶的穿刺活检以确定病理组织学类型，并制定更积极的监测和治疗方案至关重要。
