Objective: Prostate cancer is commonly diagnosed among old men while younger men are rarely diagnosed with prostate cancer. In this study we identify clinical and pathological features of 154 patients with prostate cancer younger than 55 years old and to assist intreatment decisions. Methods: The medical records of 154 prostate cancer patients younger than 55 years old in Peking University First Hospital from Feb 1953 to Jun 2016 were reviewed, retrospectively. Data was collected including symptoms, digital rectal examination (DRE), prostate-specific antigen (PSA), Gleason score, tumor stage, treatment strategies. Results: The mean age was 50.9±4.5, and 25.3% patients were between 40-50 years. Fifty-six (36.4%) patients initially presented with lower urinary tract symptoms. A solid mass could be found by digital rectal examination in 48(31.2%) patients. All patients were diagnosed by pathology of biopsy or surgery. The median Gleason score was 8. Gleason 2-6, 3+ 4, 4+ 3, 8, 9-10 were 15 cases(9.7%), 28 cases(18.2%), 21 cases(13.6%), 15 cases(9.7%), 51 cases(33.1%), respectively. Based on 2009 AJCC TNM Classification criteria the distribution of tumor stage was T1, T2, T3, and T4 in 2(1.3%), 54 (35.1%), 60 (39.0%), and 37 (24.0%) patients. Forty patients (25.9%) were found with bone metastasis and four (2.5%) suffered from visceral metastasis. Fifty-three(34.4%)underwent hormonal therapy and 79(51.3%) underwent radical prostatectomy. Conclusion: Younger prostate caner patients usually presented with LUTS symptoms and were featured for higher tumor stage and aggressiveness. More optimal and personalized risk-based therapy options are required.
目的:前列腺癌好发于中老年,青年前列腺癌(≤55岁)非常少见,临床病理特点不同于中老年患者。本研究总结青年前列腺癌患者的临床病理特点,为临床诊治提供参考。 方法:回顾性分析从1953年2月至2016年6月,北京大学第一医院泌尿外科收治的154例≤55岁的青年前列腺癌患者的临床病理资料。分析症状、体检、前列腺特异性抗原(PSA)水平、肿瘤Gleason评分、肿瘤分期、治疗方式等,总结青年前列腺癌的特点。 结果:该组患者平均年龄(50.9±4.5)岁,40岁以下4例(2.6%),40~50岁39例(25.3%),50~55岁111例(72.1%)。36.4%(56例)患者就诊原因为下尿路症状(尿频、尿急、排尿困难等)。直肠指诊可触及不规则硬结者48例(31.2%)。所有病例均经前列腺穿刺或根治手术病理证实为前列腺腺癌。130例具有Gleason评分,其中位值为8分。Gleason评分2~6, 3+4, 4+3,8,9~10患者数及占比分别为:15例(9.7%),28例(18.2%),21例(13.6%),15例(9.7%),51例(33.1%)。共153例患者具有临床TNM分期,其中T1期2例(1.3%),T2期54例(35.1%),T3期60例(39.0%),T4期37例(24.0%);骨转移40例(25.9%),内脏(肺、肝)转移4例(2.5%)。79例(51.3%)接受前列腺癌根治术,53例(34.4%)接受内分泌治疗,其余为化疗或放疗,其中根治性放疗4例(2.6%),术后辅助放疗1例(0.6%),姑息性放疗6例(3.9%)。 结论:青年前列腺癌的患者多以下尿路症状和PSA升高起病,在确诊时肿瘤分期较晚,恶性程度高,多为早发型前列腺癌,预后较差,需要采取个体化治疗的方式。.
Keywords: Age; Gleason score; Prognosis; Prostatic neoplasms; Stage.