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目的:探讨年轻前列腺癌的诊断、治疗及预后。方法:报道1例37岁前列腺癌患者的临床、病理诊断、治疗和预后,结合文献进行归纳分析。结果:2010年5月因血尿发现前列腺腺癌伴膀胱颈口浸润,分期T4N2M0,活检提示:前列腺腺癌,Gleason评分=5+4分。当时PSA 52μg/L。内分泌治疗半年后PSA 2μg/L,行腹腔镜下前列腺癌根治术+淋巴结清扫术,病理提示淋巴结转移。术后PSA最低达到0.1μg/L。术后经历放疗、内分泌治疗、二线内分泌治疗和化疗,67个月后死于多脏器功能衰竭。结论:应提高对男性前列腺癌年轻化的警惕性,建议PSA检查提前介入青年人群,治疗方面倡导内分泌、手术和放化疗等综合治疗。
Objective: To investigate the diagnosis, treatment and prognosis of young prostate cancer. Methods: The clinical, pathological diagnosis, treatment and prognosis of a 37-year-old patient with prostate cancer were reported, and the literature was summarized. Results: In May 2010, prostatic adenocarcinoma was found to be infiltrated with bladder neck due to hematuria. Staging T4N2M0 was used for biopsy. Prostatic adenocarcinoma showed a Gleason score of 5 + 4. PSA 52 μg / L at that time. After two years of endocrine therapy PSA 2μg / L, laparoscopic radical prostatectomy + lymph node dissection, the pathology prompted lymph node metastasis. Postoperative PSA reached a minimum 0.1μg / L. Postoperative radiotherapy, endocrine therapy, second-line endocrine therapy and chemotherapy, died of multiple organ failure after 67 months. Conclusion: The vigilance of male prostate cancer should be raised. It is suggested that the PSA test be involved in young people in advance and the treatment should be endorsed by endocrine, surgery and radiotherapy and chemotherapy.