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目的为了解高校老年教职工前列腺癌发病与治疗情况,回顾调查总结7年中20例前列腺癌的发现、临床诊治过程及预后。方法从2007年1月至2013年12月,共筛查发现治疗20例前列腺癌患者,均有前列腺穿刺活检或手术标本病理和前列腺特异抗原(PSA)升高资料。12例患者直肠指诊阳性,Gleason评分为3~8分;临床分期T2有11例,T3有3例,T4有6例,伴有淋巴结转移11例,肺、骨等处转移5例。7例行前列腺根治性切除术,4例行双侧睾丸切除加内分泌治疗,3例局部放疗加内分泌治疗,6例单纯内分泌治疗,其中2例为已有转移、行经尿道前列腺切除术后患者;6例后期再进行6个月内分泌治疗。结果患者全部获得随访,平均32.6个月;其中7例(35.0%)在发病及治疗后5~16个月死亡;6例PSA出现反弹后续追加6个月的药物去势(内分泌)治疗,1例仍在内分泌加局部放疗治疗中。结论高校教职工前列腺癌发病率高,“三大”初诊手段早期发现是关键,应以个体化综合性治疗为主。
Objective To understand the incidence and treatment of prostate cancer in university faculty and staff, the retrospective investigation concluded the discovery, clinical diagnosis and treatment of 20 cases of prostate cancer in 7 years. Methods From January 2007 to December 2013, a total of 20 prostate cancer patients were screened for prostate biopsy or surgical specimen pathology and prostate-specific antigen (PSA) data. Twelve patients had positive rectal fingerprints. The Gleason score ranged from 3 to 8. The clinical stage was T2 in 11 cases, T3 in 3 cases, T4 in 6 cases, lymph node metastasis in 11 cases, lung and bone metastases in 5 cases. Seven patients underwent radical prostatectomy, four underwent bilateral orchiectomy plus endocrine therapy, three under local radiotherapy plus endocrine therapy, and six undergoing endocrine therapy alone. Two of the patients had metastases and underwent transurethral resection of the prostate. Six patients were treated with endocrine therapy within 6 months later. Results All the patients were followed up for an average of 32.6 months. Seven of them (35.0%) died after onset and 5 to 16 months after treatment. Six patients with PSA rebounded and followed by additional 6 months of drug castration (endocrine) treatment, 1 Cases are still endocrine plus local radiotherapy treatment. Conclusions The incidence of prostate cancer in higher education faculty is high and the early detection of newly diagnosed “three major” diseases is the key. Individualized comprehensive treatment should be the mainstay.