前列腺癌PPT课件

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CT: 对临床分期有重要意义
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C14ollege
MRI:
五、诊 断 ( Diagnosis )
肿瘤信号不均匀,在T1加权像上常呈低信号或等信号
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C15ollege
经直肠超声引导
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C17ollege
五、诊 断 ( Diagnosis )
ECT骨扫描: 可发现骨转移病灶
Dept. of urology, The 1th AffiliateБайду номын сангаас Hospital of Kunming Medical C18ollege
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C4ollege
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 C5ollege
五、诊 断 ( Diagnosis )
MRS: 核磁波谱 ,准确性高
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C16ollege
五、诊 断 ( Diagnosis )
穿刺活检(biopsy): 确诊手段
经会阴
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
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C6ollege
三、临床表现 ( Manifestation)
1、早期:
多数无明显临床症状, 多为体检偶然发现 2、肿瘤进展期:
前列腺癌
Carcinoma of Prostate
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C1ollege
教co学nt内en容t
• 前列腺癌的临床表现及治疗
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C2ollege
c概onte述nt
流行病学 •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 C3ollege
一、病 因
病 因: 不明确 大多数与雄激素相关 多为雄激素依赖型,晚期可转为非依赖型; 雄激素非依赖型少见
• PSA值意义: < 4 ng/ml normal ; 4 ~ 10 ng/ml Grey Zone ; > 10 ng/ml highly suspect of PCa
• 准确性: 约30%前列腺癌PSA在正常范围内
• 影响因素: 导尿、前列腺炎症、直肠指检
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C12ollege
•症状体征与BPH相似: 排尿困难、尿潴留、
尿失禁、血尿、
3、转移灶表现:
(骨转移居多): 骨痛、骨折、 四肢感
觉异常
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C7ollege
四、临床分期 (Stage)
分期:
DRE : Digital Rectal Examination
Induration (硬结)
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C11ollege
五、诊 断 ( Diagnosis )
PSA :Prostate Specific Antigen
五、诊 断 ( Diagnosis )
症状体征与BPH相似,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
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C10ollege
五、诊 断 ( Diagnosis )
决定治疗措施,判断预后的参考因素
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C8ollege
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C9ollege
病理分级(最常见生长形式) +次要病理分级(次最常见生 长形式),各1-5分,分化最 好1+1=2分,最差5+5=10分。 • 意义:
五、诊 断 ( Diagnosis )
胸片、腹部 CT: 可明确有无肺、肝、肾上腺及肾脏转移
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C19ollege
六、Gleason 评 分
• 内容: 按细胞分化程度分为主要
五、诊 断 ( Diagnosis )
超 声: • 低回声灶,有助于明确病变范围 • 直肠超声TRUS准确性更高
Dept. of urology, The 1th Affiliated Hospital of Kunming Medical C13ollege
五、诊 断 ( Diagnosis )
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