前列腺小细胞神经内分泌癌1例报告并文献复习
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摘要
目的:总结前列腺小细胞神经内分泌癌的临床表现、诊断、治疗及预后,提高对其认识。方法:报告1例42岁中年男性前列腺小细胞神经内分泌癌患者,以下尿路梗阻为表现起病,肛门指检提示前列腺体积左侧增大,前列腺特异性抗原(prostate specific antigen,PSA)正常。泌尿系彩超、CT及MR提示前列腺占位。结果:前列腺穿刺活检组织病理结果显示前列腺小细胞神经内分泌癌。患者行经腹膜外途径腹腔镜下前列腺癌根治术,术后肿瘤复发并转移,采用依托泊苷联合顺铂方案化疗6个疗程,结果使肿瘤体积缩小,效果良好。结论:前列腺小细胞神经内分泌癌为临床罕见病,起病隐匿,症状不典型,以病理检查和免疫组化确诊,早期可行根治性手术治疗,术后或晚期以化疗为主,疗效肯定,生存期短,预后不良。
Objective: To summarize the clinical manifestations,diagnosis,treatment and prognosis of small cell neuroendocrine carcinoma of prostate to better understand the disease. Methods: A 42-year-old patient with small cell neuroendocrine carcinoma of prostate began his disease with symptoms of low urinary tract obstruction.Digital rectal examination showed the left side of the prostate enlarged and prostate specific antigen normal. Urinary ultrasound test,CT and MR showed prostatic cancer. Results: The pathological results of prostate biopsy showed small cell neuroendocrine carcinoma of prostate. The patient was treated by extraperitoneal laparoscopic radical prostatectomy. Results of CT reexamination found tumor recurrence and distant metastasis. Six courses of etoposide with cisplatin were given,which showed a better cancer cell killing effect. Conclusions: Small cell neuroendocrine carcinoma of prostate is arare disease with concealed onset and atypical symptoms. The diagnosis is based on immunohistochemical and pathological examination. Radical surgery is recommended in the early period of disease and chemotherapy cheers a better effect in the advanced stage or postoperation with short lifetime and poor prognosis.
Objective: To summarize the clinical manifestations,diagnosis,treatment and prognosis of small cell neuroendocrine carcinoma of prostate to better understand the disease. Methods: A 42-year-old patient with small cell neuroendocrine carcinoma of prostate began his disease with symptoms of low urinary tract obstruction.Digital rectal examination showed the left side of the prostate enlarged and prostate specific antigen normal. Urinary ultrasound test,CT and MR showed prostatic cancer. Results: The pathological results of prostate biopsy showed small cell neuroendocrine carcinoma of prostate. The patient was treated by extraperitoneal laparoscopic radical prostatectomy. Results of CT reexamination found tumor recurrence and distant metastasis. Six courses of etoposide with cisplatin were given,which showed a better cancer cell killing effect. Conclusions: Small cell neuroendocrine carcinoma of prostate is arare disease with concealed onset and atypical symptoms. The diagnosis is based on immunohistochemical and pathological examination. Radical surgery is recommended in the early period of disease and chemotherapy cheers a better effect in the advanced stage or postoperation with short lifetime and poor prognosis.
引文
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[8]夏中友,李云祥,张萌,等.前列腺小细胞神经内分泌癌1例并文献复习.中国男科学杂志,2016,30(8):55-56.
[9] Yao JL,Jonathan E. Small cell carcinoma of the prostate:a morphologic and immunohistochemical study. Am J SurgPathol,2006,30(6):705-712.
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[11]谭硕果,梁蔚波,潘斌,等.前列腺小细胞神经内分泌癌1例.广东医学,2014,35(2):331-331.
[12] Meley D,Spiller DG,Whiter MR,et al. p53 mediated delayed NF-kB activity enhances etoposide induced cell death in medulloblastoma.Cell Death Dis,2010,1(5):41-41.
[13] Califano R,Abidin AZ,Peck R,et al. Management of small cell lung cancer:Recent development for optimal care. Drug,2012,72(4):1134-1139.
[14]温爽,郭爱桃,刘爱军,等.前列腺小细胞性神经内分泌癌3例临床病理学特征分析.诊断病理学杂志,2013,20(1):25-28.
[15]程继文,蒙清贵,唐勇,等.前列腺神经内分泌癌诊治1例报告.肿瘤学杂志,2009,15(8):780-781.
[16] Simone A,Cosimo N,Andrea T,Pure small cell carcinoma of the prostate:A rare tumor. Indian J Urol,2012,28(1):89-91.
[17]刘佛林,伍耿青,盛瑶环,等.阴茎勃起神经及其分支的解剖与临床意义.赣南医学院学报,2010,30(1):90-91.
[18]聂晓枫,王增利.腹腔镜下腹膜外保留血管神经束前列腺癌根治术对患者排尿及性功能的影响.中国性科学,2016,25(12):14-17.
[2] Hingorani R,Young J,Alweis R. Mixed adenocarcinoma and neuroendocrine prostate cancer:A case report. Community Hosp Intern Med Perspect,2014,4(5):25176-25176.
[3]何海青,樊树峰,陈邦文,等.前列腺原发神经内分泌癌的CT、MR诊断.医学影像学杂志,2013,23(1):107-109.
[4] Simon RA,Sant'gness PAD,Huang LS,et al. CD44 expression is a feature of prostatic small cell carcinoma and distinguishes it from its mimickers. Hum Pathol,2009,40:252-258.
[5]郝通利,洪宝发,吴意光,等.老年前列腺小细胞神经内分泌癌的临床特点与预后.中华保健医学杂志,2010,12(2):121-123.
[6] Eble JN,Szuter G,Epstein JI,et al. WHO classification of tumours of the urinary system and male genital organs. Lyon:LARC Press,2004.
[7]刘畅,李静,贾志凌.前列腺小细胞癌误诊1例分析.中国误诊学杂志,2008,29(8):7275-7276.
[8]夏中友,李云祥,张萌,等.前列腺小细胞神经内分泌癌1例并文献复习.中国男科学杂志,2016,30(8):55-56.
[9] Yao JL,Jonathan E. Small cell carcinoma of the prostate:a morphologic and immunohistochemical study. Am J SurgPathol,2006,30(6):705-712.
[10] Mackey JR,Au HJ,Hugh J,et al. Genitourinary small cell caricinoma:determination of clinical and therapeutic factors associated with survival. J Uro,1998,159(12):1624-1629.
[11]谭硕果,梁蔚波,潘斌,等.前列腺小细胞神经内分泌癌1例.广东医学,2014,35(2):331-331.
[12] Meley D,Spiller DG,Whiter MR,et al. p53 mediated delayed NF-kB activity enhances etoposide induced cell death in medulloblastoma.Cell Death Dis,2010,1(5):41-41.
[13] Califano R,Abidin AZ,Peck R,et al. Management of small cell lung cancer:Recent development for optimal care. Drug,2012,72(4):1134-1139.
[14]温爽,郭爱桃,刘爱军,等.前列腺小细胞性神经内分泌癌3例临床病理学特征分析.诊断病理学杂志,2013,20(1):25-28.
[15]程继文,蒙清贵,唐勇,等.前列腺神经内分泌癌诊治1例报告.肿瘤学杂志,2009,15(8):780-781.
[16] Simone A,Cosimo N,Andrea T,Pure small cell carcinoma of the prostate:A rare tumor. Indian J Urol,2012,28(1):89-91.
[17]刘佛林,伍耿青,盛瑶环,等.阴茎勃起神经及其分支的解剖与临床意义.赣南医学院学报,2010,30(1):90-91.
[18]聂晓枫,王增利.腹腔镜下腹膜外保留血管神经束前列腺癌根治术对患者排尿及性功能的影响.中国性科学,2016,25(12):14-17.