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目的:探讨前列腺尿路上皮型粘液腺癌的临床表现、病理特点和治疗方法。方法:报道1例前列腺尿路上皮型粘液腺癌患者的临床诊治经过,并结合文献复习对该病临床表现、病理特点、诊断和鉴别诊断及预后等进行分析总结。结果:患者行经尿道前列腺电切术,术后病理示粘液腺癌。乙状结肠镜等内镜检查未发现原发于肠道的肿瘤。免疫组化示PSA、P504s阴性表达,而CK7,CK34βE12,CK 20和CDX2表达阳性,从而诊断为前列腺尿路上皮型粘液腺癌。给予调强适形放疗治疗。目前患者已随访30个月,一般情况良好,无局部进展及远处转移情况,效果满意。结论:前列腺尿路上皮型粘液腺癌预后差,确诊依靠病理及免疫组化。根治性前列腺切除术是治疗该病较有效的措施。该病对内分泌治疗不敏感,不适宜行根治性前列腺切除术的患者可以考虑给予放疗治疗。
Objective: To investigate the clinical manifestations, pathological features and treatment of prostatic urothelial mucinous adenocarcinoma. Methods: The clinical diagnosis and treatment of one case of prostatic uropathic mucinous adenocarcinoma were reported, and the clinical manifestations, pathological features, diagnosis and differential diagnosis and prognosis of the disease were analyzed and summarized. Results: The patients underwent transurethral resection of the prostate and histopathology showed mucinous adenocarcinoma. Sigmoidoscopy and other endoscopic examination found no primary tumor in the intestine. Immunohistochemistry showed negative expression of PSA and P504s, but positive expression of CK7, CK34βE12, CK 20 and CDX2, which was diagnosed as prostate urothelial mucinous adenocarcinoma. To strengthen the intensity of conformal radiotherapy treatment. The patient has been followed up for 30 months, the general situation is good, no local progress and distant metastasis, the effect is satisfactory. Conclusions: Prostatic urothelial mucinous adenocarcinoma has a poor prognosis and confirmed by pathology and immunohistochemistry. Radical prostatectomy is more effective treatment of the disease measures. The disease is not sensitive to endocrine therapy, not suitable for radical prostatectomy in patients with radiotherapy can be considered for treatment.