PROSTATE CANCER

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.

The prostate is wrapping men beneath the bladder, urethra around the size of an iron-like gland for men unique. According to statistics, China's annual 7 ~ 80,000 new cases of prostate cancer, 95% occurred in people older than 60, prostate cancer incidence continued to increase with increasing age. Clinical found that prostate cancer occurred in the posterior lobe, and no more early symptoms, even some discomfort, would not be enough to cause the patient's attention. When the tumor increased urethral compression, often confused with BPH. The club, about 80% of the patients first discovered lesions distant metastasis, and then found that prostate cancer. At this time, advanced lesions have a poor prognosis. Thus, the early detection of prostate cancer is clearly important.

Prostate cancer is the male reproductive system common malignancy. Our incidence is lower than Europe and the United States, but nearly 20 shows a rising trend. The incidence of prostate cancer in parallel with age, according to statistics, few men under the age of 50; 50-60 years the incidence of prostate cancer 1 / 3; Above the age of about 70 1 / 2; Over the age of 80 accounted for about 3 / 4.

1. Potential prostate cancer: is not in his prostate disease signs and symptoms in the death of the autopsy pathology examination revealed the primary adenocarcinoma of the prostate. Potential prostate cancer can occur in any location, but the central area and peripheral areas seen, and often well-differentiated adenocarcinoma. The incidence of reported abroad for 15% to 50%. Urological Research Institute of China's Hebei reported latent prostate cancer incidence rate was 34%. Statistical studies show that the incidence of prostate cancer may be latent and environmental and genetic factors.

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.