PROSTATE CANCER

Prostate cancer is the male reproductive system common malignancy. Prostate below the bladder in a chestnut-shaped gland, in the middle through the urethra. It is the secretion of sperm liquid nutrient solution is a component of semen. Benign prostate enlargement and prostatitis produce similar symptoms and cancer. Prostate cancer mainly primary site for posterior subcapsular gland, was latent slow growth, a tumor hours without any clinical manifestation. Thus the advanced prostate cancer generally only show symptoms. A clinical disease duration and often asymptomatic B, C obstructive symptoms of a period, and D both distant metastasis obstructive symptoms have symptoms.

The cause of prostate cancer has not been identified, may be genetic, environmental, and the sex hormones. Prostate androgen secretion by the testis nine ketone conditioning, gonadotropin luteinizing hormone indirect role to play. Juvenile emasculated never occurred to prostate cancer.

Prostate cancer is 98% adenocarcinoma, often from prostate shrinkage of the peripheral part of a majority of more lesions. The transfer of the disease have three ways: 1 to nearby or adjacent organ invasion organizations, and both sides of the first transgression, pierced envelope to vasectomy ampulla, spermatheca, bladder neck and urethra policies; ② lymph node metastasis may fall to para-aortic lymph node and beyond; ③ blood is the most common bone metastasis and poor, spine , femur. Severe pain. , Pathologic fractures can occur. Also transferred to the liver, lung, pleura, adrenal gland, brain and other organs.

A basic treatment programs
Prostate cancer treatment can be divided into surgical treatment, hormonal therapy, radiotherapy, chemotherapy and treatment in Chinese medicine. Specific selection of the program, according to the patient's age, systemic symptoms, the cancer staging, state immunity and comprehensive consideration. General radical surgery for early adopters, five-year survival rate 75% 10 55% survival rate, 15-year survival rate of 33%. The frail elderly or have complications or pelvic metastasis of patients, radiotherapy should be OK, five-year survival rates of 60%, 10-year survival rate 39%. Using advanced endocrine, chemical treatment and Chinese medicine.

A diagnosis
(1) clinical diagnosis
1. Early symptoms may developed symptoms of advanced prostate hyperplasia with a similar obstructive symptoms. Because cancer metastasis to the bone, lumbosacral pain, sciatica, nerve paralysis, accompanied by weight loss, fatigue, loss of appetite and other systemic symptoms.
2. Digital rectal examination is a rock-hard prostate nodule, its boundaries unclear, mass sizes, or a few millimeters or large and fixed.
3. Laboratory ACP, AKP increase in transfers. PSA, PAP in the diagnosis of prostate cancer is a certain sense.
4. Ultrasound imaging examination revealed the prostate hypoechoic lesions. See X-ray examination of the bone changes that increased density of the shadow, we can see that osteolytic lesions transfer or mixed; THE chest lung metastases can be found. CT and MRI scans of the prostate that can be changed, occupying lesions and metastases. ECT earlier than X-ray found bone metastatic lesions.
5. Prostate Needle aspiration biopsy of the prostate can be diagnosed as a method used 6:00 puncture biopsy system.
More clinical staging method is not yet unified. Ts are commonly used phased improvement of law and TNM staging.
1. Improved staging of ts
A: Most of incubation. Clinical found no tumors, prostate digital rectal examination without change, found only in the examination of tumor cells and tumor cells in good, normal serum acid phosphatase.
A1 period: only confined to the prostate tumor lesions within one to two small regions.
A2 period: multiple tumor foci were still confined to the prostate.
B: Tumor confined to the prostate, but the digital rectal examination can be touched. The digital rectal examination can be divided into the following two.
B1 period: tumor nodules confined to the side of the prostate with less than 1.5 cm in diameter.
B2: tumor involvement Hitotsuba above or greater than 1.5 cm in diameter, but not over-coated. Normal serum acid phosphatase.
Stage C: Most violations have prostate cancer, benign prostatic capsule penetration violations spermatheca, bladder neck and pelvic bilateral or other pelvic organs, there is no transfer. Serum phosphorus acid normal or elevated enzyme.
C1 period: no cancer and seminal vesicle invasion.
XC2 period: seminal vesicle involvement or other pelvic organs.
D: Clinical and pathological have transferred. 2 / 3 cases of elevated serum acid phosphatase.
D1 period: pelvic lymph node metastasis in the aortic bifurcation.
D2 period: aortic bifurcation more lymph nodes and other organs and bone metastasis.
2.1974 Initiative, the International Union of TNM staging
The primary tumor (T) phases:
Tx: occasionally cancer (carcinoma in situ)
T0: the original tumor was found.
T1: tumor of the prostate 1 / 2 below normal size gland.
T2: tumor of the prostate 1 / 2 or 1 / 2 above, nor increase gland.
T3: tumor confined to the gland, but gland increases.
T4: the gland tumor,.
Regional lymph nodes (N) phases:
Nx: lymph nodes situation can not be estimated.
N0: No change lymph nodes.
N1: local lymph nodes deformation.
N2: can be fixed palpable abdominal lymph nodes.
Distant metastasis (M) stages:
M0: no transfer.
M1: metastasis.
Vaccine: Only bone metastases.
FDA: other parts of the transfer, with or without bone metastases.
2, differential diagnosis
1. Prostate tuberculosis prostate sclerosis, it is similar with prostate cancer. But younger patients, reproductive system other organs, such as the seminal vesicle, vas deferens, epididymis tuberculous lesion or urinary tuberculosis symptoms, such as frequency, urgency, novel urethral secretions, blood and sperm. Tuberculosis prostate nodule for local infiltration, texture than they. Urine, prostatic fluid, semen with red, IL. X-ray shadow sometimes visible calcification prostate, prostate biopsy pathology typical TB change.
2. Prostate stone for stone prostate digital rectal examination, ahead of prostate, palpable calculus of a hard twist of the flu. Pelvic X-ray shadow of stone that the prostate; Ultrasonography showed that the prostate area with the light acoustic shadow.
3. Nonspecific granulomatous disease prostatitis nodules developed rapidly, with peak-like protrusions, hard and soft mixed, but resilient. The treatment of antibiotics and anti-inflammatory medication 1-2 months sclerosis smaller. Hard Festival prostate biopsy, endoscopic rich in non-caseating granulomas, full of epithelioid cells, foam cells, around lymphocytes, plasma cells, eosinophils, the gland often rupture expansion, with inflammatory cells.
4. Prostate nodular hyperplasia prostate showed diffuse increased, smooth surface, there are nodules flu; PSA general in the normal range; Prostate ultrasonography increased its points-in uniform, prostate capsule for reflection, clearly limits its surrounding tissue.
5. The incidence of prostate sarcoma with high youth, children accounted for 1 / 3; Condition rapid development, shorter duration. Digital rectal examination prostate enlargement, but flexible texture, soft as cystic more with lung, liver, bone metastasis and other clinical symptoms.

[Transfer and disseminated]

The higher the degree of malignancy of prostate cancer, early local infiltration will be clear and lymph node metastasis and tumor often violated seminal vesicle and bilateral lesions, few violations of the rectum. Along the lymphatic metastasis to the nearby pelvic lymph nodes, then transferred to the internal iliac, the skeleton, abdominal aortic adjacent mediastinal lymph nodes, and supraclavicular lymph nodes. Prostate cancer can fool to bone metastasis, the most common is the pelvis, lumbar spine, femur and ribs. Blood Road also can be transferred to the lung, liver, kidney, brain and other organs.

Prostate cancer gene from the loss, it is pathological in Shanxi Tumor Hospital director Wang Hung-wide applications such as microdissection, from the level of gene detection of prostate cancer origin concluded.

Prostate cancer in cancer mortality in men, lung cancer has been beyond the second one. Because the disease is a combination of multiple genes changed tumor, pathological changes and the clinical performance of a variety show, according to morphology and cell carcinoma lesions of the reasons for the judgment of the traditional methods highly inaccurate, often leads to the treatment of the blind, affecting prognosis.