摘要目的 探讨pT0期前列腺癌的临床病理特征及预后.方法 回顾性分析2004年11月至2017年5月我院8例行根治性前列腺切除术后病理分期为pT0期前列腺癌患者的临床资料,除外术前已行新辅助内分泌治疗及经尿道前列腺切除术(TURP)术的患者.年龄63 ～ 75岁,平均69.1岁;PSA 2.26 ～ 14.10 ng/ml,平均6.10 ng/ml;f/t PSA0.10 ～0.31,平均0.22;前列腺体积30.3 ～72.1 ml,平均52.1 ml.由一名高级职称泌尿专业病理医师重新审阅所有前列腺穿刺活检标本和术后大体病理标本,并重新做出诊断.随访患者生化进展及生存情况.结果 8例术后大体病理结果未见前列腺癌,经泌尿专业病理医师重新审阅穿刺及大体病理标本后,7例仍未见前列腺癌组织,1例于前列腺左叶基底部外周带发现直径2 mm的癌灶,Gleason评分3+3分.8例患者平均随访时间75个月,其中1例术后第5天因肺栓塞死亡,其余7例患者均健在,PSA控制满意,均未出现生化复发,无生化进展.结论 对于经前列腺穿刺活检确诊且术前未行新辅助治疗的前列腺癌患者,可能出现pT0期前列腺癌这一少见的病理现象,此类患者远期肿瘤学预后良好.

abstractsObjective To analyze the clinical and pathological characteristics and prognosis of stage pT0 prostate cancer patients after radical prostatectomy.Methods From November 2004 to May 2017,eight patients who underwent radical prostatectomy and postoperatively diagnosed with pT0 were retrospectively evaluated.The patients aged 63-75 years (mean 69.1 years),with PSA 2.26-14.10 ng/ml(mean 6.10 ng/ml),prostate volume 30.3-72.1 ml (mean 52.1 ml).Exclusion criteria included patients undergoing neoadjuvant hormone therapy or TURP before the operation.Stage pT0 prostate cancer was defined as no evidence of residual tumor in radical prostatectomy specimen from the patient in whom biopsy-proven prostate carcinoma was histologically diagnosed.The clinical and pathological data were reviewed and follow-up was performed for stage pT0 prostate cancer patients.Biochemical progression was defined as postoperative PSA greater than 2 ng/ml for twice.The patients were followed-up.Results Eight patients (1.1％) were postoperatively diagnosed with prostate cancer of pT0 stage.After radical prostatectomy specimen was reexamined by an uropathological expert,small residual tumor(2mm) was found in left peripheral zone of the prostate in one patient.The average follow-up duration was 75 months for this 8 pT0 patients.One patient died of pulmonary embolism after 5 days of the surgery.No patient had evidence of biochemical progression.No biochemical recurrence survival rate and cancer-specific survival rate was 100％ (7/7) and overall survival rate was 87.5％ (7/8) for pT0 prostate cancer patients.Conclusions For patients who were biopsy-proven prostate cancer without neoadjuvant hormone therapy,stage pT0 was a rare pathological phenomenon.Those patients had a very favourable oncological prognosis.