PROSTATE CANCER

Because prostate cancer occurred in the posterior lobe, slow growth, was buried after, the early muscle, once the symptoms are often relatively late. The main performance of advanced prostate cancer for lower urinary tract obstruction, or with hematuria and urinary retention. The most prominent symptom is pain.

(A) voiding dysfunction: 80% of the patients tumor caused by the sexual difficulty urinating, urinary flow fining or partial distortion, or urinary bifurcation, urine-extended frequency, urgency, novel, urine intended not flu, serious drop Lek and the outbreak of urinary retention. Only 3% of patients hematuria.

Prostate cancer generally slower development, can be asymptomatic. There will be advanced disease bladder outlet obstruction or ureteral obstruction symptoms or hematuria. Transferred to the pelvis, ribs and vertebrae can cause pain. Locally Advanced Prostate cancer can spread to the performance of the seminal vesicle sclerosis, glands fixed to the side.

Digital rectal examination found abnormal transrectal ultrasound (TRUS) shows hypoechoic lesion or serum prostate-specific antigen (PSA) levels in prostate cancer should be suspected. However, histological diagnosis be confirmed, is the most commonly used transrectal ultrasound guided transrectal biopsy, the patient may biopsy , without anesthesia. there nerve peripheral lymphoid infiltration of diagnostic value. occasionally removed from surgery for suspected benign prostatic increased in malignant transformation can be found in diagnosis of prostate cancer.

A digital rectal examination
Because prostate cancer occur in the prostate gland posterior subcapsular leaves, it digital rectal examination in the diagnosis of prostate cancer accounted for a very important position on prostate cancer diagnosis and staging of vital significance. Checks should pay attention to prostate size, shape, whether irregular nodules, prostate volume expansion of the central sulcus, glandular activity, hardness and seminal vesicle, and so on. If it refers to the seizure, in prostate cancer as well. More patients aged over 50. Generally, prostate cancer nodules in hard as a rock, uneven, central sulcus disappear glands fixed, and even direct violation of the wall. But the difference was significant, infiltration and larger lesions may change as the relatively soft. Checks need attention.
2, laboratory examination and inspection Radioimmunoassay
1. Serum acid phosphatase (ACP), alkaline phosphatase (AKP), both of prostate cancer are increased, particularly in the diagnosis of prostate cancer ACP more sensitive, 65% distant metastasis ACP increased without distant metastasis were 20% of the ACP increased. If using radioimmunoassay ACP, will enhance the early diagnosis of prostate cancer, the positive rate was 73.7%. As the disease and the development of its positive rate also increased. Can be used to monitor the progression of prostate cancer. But ACP determination may have false-negative and false, but not rectal examination and urethral inspection within 24 hours after the inspection. Attention should be.
2. Smear prostatic fluid cytology examination of this high accuracy rate, it is reported up to 86%, but may cause prostate massage proliferation of prostate cancer, should not be used as a clinical method.
3. Benign prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) screening PAP detection sensitivity and specificity than ACP high. But since PSA testing after the application has been replaced. PSA is produced by the prostate epithelial a sugar protease, normal serum PSA less than 5 μ g / L, when more than 10 μ g / L, to consider the possibility of prostate cancer. PSA has become a cancer diagnosis before the sensitive indicators. But not because of their high specificity, clinical use is subject to restrictions. In recent years the percentage of free PSA determination, a sensitivity and specificity of PSA increase.
3, ultrasonic inspection
With the special insert rectal ultrasound probe, the prostate can cut loose screen, reflecting lights up the lesion area. In B-rectal ultrasound probe developed into three-dimensional image-focused, to enhance diagnostic value. Prostate cancer ultrasound examination showed inhomogeneous internal reflection in the light, hypoechoic region or group of Spot. Advanced prostate cancer, not for reflection coated tumor and surrounding tissue boundaries unclear, suggesting that a local infiltration, and the envelope infiltration degree classification for diagnosis. This objective can be increased to the extent that prostate Institute and State. Because of this examination is painless, non-invasive inspection, it can be used for early diagnosis.
4, X-ray inspection
(1) imaging
1. Prostate contrast to the perineal prostatectomy puncture injection B iodine tablets pelvis after perturbation, that the entire prostate, prostate can be found in isolated, less than a finger touch nodule. Method: Local anesthesia after disinfection, the finger guided by the puncture to the perineal prostatectomy, the first injection of Lipiodol 0.2ml B] after pelvic tablets to determine puncture in the prostate after injection of Lipiodol 2 ~ B treatments. Because a majority of only puncture the side of the prostate that, it takes the same approach for prostate screening with the other side.
2. IVP right understanding of the situation is necessary urinary tract, and may provide clues to the spread of prostate cancer. After voiding X-ray can show noninvasive residual urine volume. If a urinary tract showed that the water is suggested that the former has advanced adenocarcinoma, affecting bladder triangle bilateral ureteral orifice urine drainage.
3. Lymphatic angiography in the diagnosis of prostate cancer has some value to speculate on lymph node metastasis of prostate cancer, prognosis and treatment of the development are of great significance. It is reported up to 86% accuracy rate. But the dorsal lymph angiography can show that the earliest obturator lymph node metastasis and internal iliac lymph nodes, angiography showed 1cm when filling defect can be diagnosed over the transfer. The difficulty that small metastases. Therefore methods in clinical application is limited.
(2) the skeletal system and lung X-ray
Because prostate cancer often have bone metastasis and lung metastasis, it chest and bone X-ray examination of the importance of cancer staging. Although the body can transfer any bones, pelvic and lumbar but is the most common site of metastasis early. Skeletal radiography inspection system should include the pelvis, spine, ribs, femur, skull, X-ray showed a bone or osteolytic performance. All right chest X-ray lung metastasis judgment significance of X-ray often shows massive shadow or miliary shadow.
5, CT and MRI
The fault resolution factors and the reasons for the smaller early diagnosis of prostate cancer often do not, but to determine local tumor invasion and lymph node spread of advanced local help. Prostate cancer can be carried out in phases to help the anti-election reasonable treatment and prognosis.
6, radioactive nuclear scan (ECT) Checks
Radionuclide scanning used to diagnose prostate cancer bone metastasis than X-ray found bone metastases as early as six months time around. Recessive bone metastases particularly sensitive. The patients were followed up and prognosis, than for bone scans or X-ray inspection of serum acid phosphatase higher sensitivity.
7, prostate aspiration biopsy
Prostate cancer depend on the final pathological diagnosis. In a partial-proliferation and metastasis, a prostate biopsy within sclerosis, and early diagnosis can be made. The original finger-guided prostate puncture, because sometimes inaccurate puncture position, the positive rate is not high. Application in prostate ultrasound-guided puncture, accuracy greatly enhanced. Transperineal prostate puncture accuracy rate of 86%, transrectal prostate wear up to 80% ~ 95%.

Prostate cancer incidence rates high in Europe and the United States, second only to lung cancer in elderly men, but relatively rare in China, the incidence rate of increase in recent years.

[Causes pathological]

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.

Male prostate cancer incidence rates in increasingly high, but found the majority of patients is already late. Known appropriate supplementary vitamins A, C, E, green tea and soy products category can be prevented, obesity and high cholesterol are risk factors.

Prostate cancer generally good in the age between 65 to 75 years old, male-specific cancer, in recent years the use of DRE and serum prostate specific antigen (PSA) testing, early detection of prostate cancer, and after surgery or hormone therapy, the five-year survival rate reached 70%.

① digital rectal examination: Hard nodules found, the correct rate of 80%;

② puncture or transrectal prostate biopsy perineal incision more accurate;

③ acid phosphatase in serum: significantly increased.

④ ultrasound, isotope scanning: Prostate have changed.

⑤ X-ray: urethral contrast policies after transurethral bladder neck displacement; The spine, pelvis, femur, sternum radiography, see a metastatic lesion of bone destruction.