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目的:探讨含有5种不同组织学结构的前列腺癌的临床表现、病理特征、治疗方法。方法:报告1例含有5种组织学结构的前列腺癌的临床资料,并结合文献对其诊断、病理、治疗等进一步分析。结果:患者直肠指检、B超、CT、MRI及PSA均提示前列腺癌,行穿刺活检后确诊。考虑患者全身状况行硬膜外麻醉下经尿道前列腺电切术以改善排尿症状。术中切除可疑肿瘤组织,术后病理:前列腺腺癌(筛状癌、腺泡癌、浸润癌、导管癌、黏液腺癌)。Gleason分级9分。术后应用比卡鲁胺和醋酸戈舍瑞林治疗,术后10个月开始出现全身转移,术后1年死亡。结论:含有5种不同组织学结构的前列腺癌极其罕见,难于早期诊断,确诊主要依靠病理和免疫组化检查。
Objective: To investigate the clinical manifestations, pathological features and treatment of prostate cancer with five different histological structures. Methods: One case of prostate cancer with five histological structures was reported, and its diagnosis, pathology and treatment were further analyzed according to the literature. Results: The digital rectal examination, B-ultrasound, CT, MRI and PSA all showed prostate cancer and confirmed by biopsy. Consider the general condition of the patient undergoing transurethral resection of the prostate with epidural anesthesia to improve urination symptoms. Surgery excision of suspicious tumor tissue, postoperative pathology: prostate adenocarcinoma (reticular carcinoma, acinar carcinoma, invasive carcinoma, ductal carcinoma, mucinous adenocarcinoma). Gleason graded 9 points. After the application of bicalutamide and goserelin acetate treatment, the onset of systemic metastases after 10 months, 1 year after the death. Conclusion: There are five different histological structures of prostate cancer is extremely rare, difficult to early diagnosis, diagnosis depends mainly on pathology and immunohistochemistry.