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目的 :提高前列腺癌的诊断水平。方法 :对 1980年 1月～ 1999年 5月收治的 16 1例前列腺癌根据临床症状、直肠指检、B超、CT、MRI、活检、瘤标及同位素骨扫描 ,分析其诊断价值。结果 :临床症状中排尿不畅 15 4例(95 6 % ) ,尿潴留 30例 (18 6 % ) ,血尿 5 6例 (34 8% ) ,骨痛、消瘦 8例 (4 9% ) ,截瘫 2例 (1 3% ) ;直肠指检 ,前列腺质地坚硬 12 7例 (78 9% ) ,可触及结节 119例 (73 9% ) ,腺体表面高低不平 47例 (37 1% ) ;B超检查 :前列腺体积为2 4— 15 1ml,腺体增大凸入膀胱 2 7例 (2 1 1% ) ,内部强回声 14例 (10 9% ) ,低回声 5 8例 (4 5 3% ) ,前列腺两侧叶不对称 ,伴高低不平 31例 (2 4 2 % ) ,浸润膀胱颈部和三角区 14例 (10 9% ) ,侵润精囊 11例 (8 6 % ) ;有 46例行经直肠B超引导下穿刺活检 ,其中阳性 42例 (91 3% ) ,PSA检查 93例 ,其中PSA <4μg/L10例 (10 8% ) ,PSA 4— 10 μg/L 9例 (9 7% ) ,PSA 10— 10 0 μg/L 41例 (4 4 1% ) ,PSA >10 0 μg/L 33例 (35 5 % ) ;同位素骨扫描 10 8例 ,正常骨显像 2 2例(2 0 4% ) ,多发放射性浓聚灶 81例 (75 3% ) ,孤立性浓影可疑转移灶 5例 (4 6 % )。结论 :临床症状、影像学检查、PSA及同位素骨扫描是诊断前列腺癌的重要临床依据
Objective: To improve the diagnosis of prostate cancer. Methods: The diagnostic value of 16 1 cases of prostate cancer from January 1980 to May 1999 was analyzed based on clinical symptoms, digital rectal examination, ultrasound, CT, MRI, biopsy, tumor markers and isotope bone scan. Results: 15 4 cases (95 6%) had urinary retention, 30 cases (18 6%) had urinary retention, 56 cases (34 8%) had hematuria, 8 cases had pain or emaciation (49%), paraplegia 2 cases (13%); digital rectal examination, 12,7 cases (78.9%) of the prostate had a hard texture, 119 cases of accessible nodules (73.9%) and 47 The ultrasonography showed that the volume of the prostate was 2 4-15 ml, the enlargement of the gland was 27 cases (21.1%) which protruded into the bladder, 14 cases (109%) had internal strong echo, and 58 cases (453% ), Asymmetrical leaves on both sides of the prostate, with unevenness in 31 cases (22.4%), infiltration of the bladder neck and trigone in 14 cases (109%), invasion of seminal vesicle in 11 cases (86%); 46 cases There were 42 cases (91.3%) positive for PSA and 93 cases for PSA in 10 cases (10.8%) with PSA <4μg / L and 9 cases (PSA with PSA 4- 10μg / L) (41%) with PS 10-10 μg / L and 33 cases (35.5%) with PSA> 100 μg / L. There were 108 cases of bone scintigraphy and 22 cases of normal bone scintigraphy There were 81 cases (75 3%) of multiple radioactive focal stoves and 5 cases (4 6%) of suspicious metastatic solitary thick shadow cases. Conclusion: Clinical symptoms, imaging examination, PSA and isotope bone scan are important clinical evidences for the diagnosis of prostate cancer