本文選題：惡性間葉腫瘤 + 前列腺�。� 參考：《浙江大學》2014年碩士論文

【摘要】：背景： 前列腺惡性間葉腫瘤(prostatic malignant mesenchymal tumors, PMMT)指發(fā)生于前列腺的各類罕見的惡性間葉腫瘤,如平滑肌肉瘤、胚胎橫紋肌肉瘤、惡性纖維組織細胞瘤、骨肉瘤、軟骨肉瘤、惡性外周神經(jīng)鞘瘤、間質(zhì)肉瘤等。雖然PMMT種類繁多,但發(fā)病率卻極低。國外文獻報道前列腺肉瘤發(fā)生率占前列腺惡性腫瘤的0.10%-0.24%。由于腫瘤進展快,且早期無明顯癥狀,就診時大都已局部或全身轉移,加之臨床診療方法尚不統(tǒng)一,療效不確實,故總體預后較差,已引起學者的重視。 鑒于此,本研究通過對我院近十年來收治的20例前列腺惡性間葉腫瘤患者的臨床資料作整理分析并文獻復習,旨在提高對該病的認識和診治水平。材料與方法： 本文收集了浙江大學附屬第一醫(yī)院泌尿外科自2003年1月-2013年1月診治的20例PMMT患者的臨床資料,通過病史、體格檢查、實驗室檢查、彩色多普勒超聲、CT、MRI、前列腺穿刺活檢和術后標本常規(guī)病理檢查和免疫組化等結果,采用生存分析方法(Kaplan-Meier)進行比較分析并繪制生存曲線,Log-Rank檢驗生存率差異(統(tǒng)計軟件采用SPSS軟件19.0版本)。并結合文獻來探討PMMT的診斷、治療及預后。 結果： 20例患者中,常規(guī)病理和免疫組化確診7例為平滑肌肉瘤,5例為橫紋肌肉瘤,3例為間質(zhì)肉瘤,1例為軟骨肉瘤,4例為未分型惡性間葉腫瘤。13例行根治性前列腺切除術,其中6例行術前或術后放化療(包括Ⅰ期2例,Ⅱ期3例,Ⅲ1例)；2例行盆腔腫塊切除術(術前均行動脈栓塞),1例(1/2)行術后化療(Ⅱ期1例,Ⅲ1例)；1例行全盆器官切除術(Ⅱ期1例)；1例因盆腔內(nèi)多發(fā)轉移瘤并兩側精囊腺累及,行姑息性結腸造瘺術+盆腔淋巴結活檢術(Ⅲ1例)；3例因術前影像提示已肺、盆腔、骨骼等轉移而行化療放療和中藥等保守治療(Ⅳ期3例)。本組中9例(9/20)治療后3月內(nèi)腫瘤全身轉移而死亡；3例(3/20)分別為術后6月、7月及14月死亡；3例(3/20)分別帶瘤存活5月、11月、12月；2例(2/20)無瘤存活至今已12月、24月,均為術后行周期性化療者；3例(3/20)失訪。 結論： 前列腺惡性間葉腫瘤發(fā)病年齡輕,惡性程度高,進展快,總體預后較差；診斷PMMT通常以經(jīng)直腸超聲引導下穿刺活檢完成,確診主要依靠病理和免疫組化；臨床分期是影響預后的重要因素,早期診斷和以根治性前列腺切除為主的綜合治療可以顯著提高患者生存率。
[Abstract]:Background:
Prostatic malignant mesenchymal tumors (PMMT) refers to a variety of rare malignant mesenchymal tumors occurring in the prostate, such as leiomyosarcoma, embryonic rhabdomyosarcoma, malignant fibrous histiocytoma, osteosarcoma, chondrosarcoma, malignant peripheral neurilemmoma, stromal sarcoma, and so on. Although a wide variety of PMMT, the incidence of the disease However, it is reported that the incidence of prostatic sarcoma in foreign literature accounts for the 0.10%-0.24%. of the malignant tumor of the prostate, which is rapidly progresses and has no obvious symptoms at the early stage. Most of them have local or systemic metastases at the time of treatment. In addition, the clinical diagnosis and treatment methods are not uniform and the curative effect is not true. Therefore, the general precondition is poor, which has aroused the attention of the scholars.
In view of this, the clinical data of 20 cases of malignant mesenchymal tumor of the prostate were analyzed and reviewed in our hospital for the last ten years. The purpose of this study was to improve the understanding and diagnosis and treatment of the disease.
The clinical data of 20 patients with PMMT from the Department of Urology, the First Affiliated Hospital of Zhejiang University, from January 2003 -2013 January, were collected. The results of the medical history, physical examination, laboratory examination, color Doppler ultrasound, CT, MRI, prostate biopsy and routine examination of postoperative specimens and immunohistochemistry were used, and the survival analysis method was used (K Aplan-Meier) make a comparative analysis and draw a survival curve, Log-Rank test the difference of survival rate (the statistical software uses SPSS software version 19). Combined with the literature to explore the diagnosis, treatment and prognosis of PMMT.
Result錛，

本文編號：2038181