文档介绍：Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College 前列腺癌 Carcinoma of Prostate Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College content ?前列腺癌的临床表现及治疗教学内容 Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College content 流行病学概述?欧美:前列腺癌发病率极高,仅次于肺癌?我国:发病率相对较低,但增长明显 Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College 病因: 不明确多为雄激素依赖型,晚期可转为非依赖型多为雄激素依赖型,晚期可转为非依赖型; ; 大多数与雄激素相关雄激素非依赖型少见一、病因 Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College 二、病理病理: ? 98% 为腺癌;肉瘤少见?多发生于外周带 Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College 二、病理病理: ?转移:局部、淋巴及血行?血行: 最多见为脊柱、骨盆等骨转移最多见为脊柱、骨盆等骨转移 Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College 1、早期: 3、转移灶表现: 2、肿瘤进展期: 多数无明显临床症状, 多为体检偶然发现多为体检偶然发现(骨转移居多): 骨痛、骨折、四肢感觉异常?症状体征与 BPH 相似: 排尿困难、尿潴留、尿失禁、血尿、三、临床表现( Manifestation) Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College 四、临床分期(S tage ) 分期: 分期: 决定治疗措施,判断预后的参考因素 D期 C期 B期 A期 Whitmore- Jetwett 病灶范围 T4 T3 T2 Tx、T0、T1 TNM 局部淋巴结或远处转移(扩散癌扩散癌) 穿透包膜,侵及邻近组织(包膜外癌包膜外癌) 局限在包膜内可扪及( (包膜内癌包膜内癌) 直肠指检及影像学未发现(偶发癌偶发癌) 分期系统 Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College Dept. of urology, The 1th Affiliated Hospital of Kunming Medical College 五、诊断( Diagnosis ) 症状体征与 BPH 相似, 肛门指检是重要的初筛方法肛门指检是重要的初筛方法辅助检查: 查血 PSA 、B超、 CT 、 MRI 、骨扫描、穿刺活检等