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目的 了解药物去势治疗后前列腺癌骨转移灶的组织变化。 方法 对 7例前列腺及骨转移灶穿刺结果阳性的前列腺癌骨转移患者采用药物去势治疗 ,对比观察原发肿瘤和骨转移灶组织去势前后变化。 结果 7例治疗后 2个月前列腺肿物消失。 5例PSA在 2个月内恢复至正常水平 ,其中 2例因脊髓压迫症状行骨科手术 ,骨病灶病理检查发现腺泡型癌细胞消失 ,肿瘤骨小梁数量减少 ,免疫组化PSA染色阴性。 2例局部骨灶进行性发展者行骨病灶切除 ,病灶处组织学检查发现腺泡型癌细胞 ,其中夹杂大量的肿瘤样骨组织 ,免疫组化PSA染色阳性。PSA及影像学检查见有与骨灶局部改变相对应的表现。 结论 去势治疗可使前列腺及骨转移灶的肿瘤细胞部分或全部消失 ,PSA及影像学检查可表现出骨转移灶的相应变化 ,并为治疗提供确切依据。
Objective To investigate the histological changes of bone metastases in prostate cancer after drug castration. Methods Seven patients with prostatic cancer and bone metastases who had positive prostatic cancer bone metastases were treated with drug castration. The changes of primary tumor and bone metastases tissues before and after castration were observed. Results 7 cases of prostates disappeared 2 months after treatment. Five patients returned to their normal levels within 2 months. Two patients underwent orthopedic surgery due to spinal cord compression symptoms. The acinar carcinoma cells disappeared, the number of trabecular bone was reduced, and the immunohistochemical staining was negative. 2 cases of local development of bone lesions were removed bone lesions, histological examination of lesions found acinar cancer cells, which mixed with a large number of tumor-like bone tissue, immunohistochemical staining positive for PSA. PSA and imaging examination showed that the local changes associated with the performance of bone lesions. Conclusion Ovariectomized treatment can partially or completely eliminate the tumor cells in prostate and bone metastases. PSA and imaging examination can show the corresponding changes in bone metastases and provide exact evidence for the treatment.