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目的:探讨正常血清PSA进展期前列腺癌患者的诊断及治疗方法,提高前列腺癌的诊疗水平。方法:回顾性分析2010年收治的1例正常血清PSA进展期前列腺癌患者临床资料,结合相关文献,讨论正常血清PSA进展期前列腺癌的诊断及治疗方法。结果:患者血清PSA水平一直处于正常水平,经病理学检查证实为前列腺癌,临床分期为T4N0M0,行前列腺去势术+抗雄激素治疗,现已无进展生存15个月。结论:正常血清PSA进展期前列腺癌多系特殊病理类型的前列腺癌,预后相对较差。在进行PSA筛查时,需综合考虑f/tPSA比值;术后随诊时需定期进行影像学检查,以了解有无疾病进展;治疗上除采取内分泌治疗外,必要时宜早期采用放疗及化疗。
Objective: To investigate the diagnosis and treatment of prostatic cancer in patients with advanced normal serum PSA and to improve the diagnosis and treatment of prostate cancer. Methods: A retrospective analysis of 2010 cases of normal serum PSA in patients with advanced prostate cancer clinical data, combined with the literature to discuss the diagnosis and treatment of advanced prostate cancer in normal serum PSA. Results: The level of PSA in patients was always at normal level. The pathological examination confirmed that it was prostate cancer. The clinical stage was T4N0M0. Prostatectomy + anti-androgen therapy was performed. No progress was observed for 15 months. Conclusion: Prostate cancer with multi-line special pathological type of prostate cancer with normal serum PSA is relatively poor prognosis. In the screening for PSA, the need to take into account the f / tPSA ratio; postoperative follow-up regular radiological imaging to understand the progress of the disease; treatment in addition to take the endocrine therapy, if necessary, the early use of radiotherapy and chemotherapy.