前列腺黏液腺癌多学科诊疗模式诊治2例报告及文献复习

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Diagnosis and treatment of prostate mucosa adenocarcinoma under multidisciplinary diagnosis and treatment mode：2 cases report and literature review

WU Peng WANG Fuli ZHANG Jing REN Jing QUAN Zhiyong XU Wanni WEI Lichun QIN Weijun1

ABSTRACT：Objective To explore the clinicopathological characteristics and comprehensive treatment strategies of prostate mucosa adenocarcinoma under multidisciplinary diagnosis and treatment （MDT） mode.Methods Data of two patients with typical prostate mucosa adenocarcinoma treated in our hospital during Sep.2020 and Apr.2023 were retrospectively analyzed.Results In case the clinical manifestation was macroscopic hematuria；multiparametric magnetic resonance imaging （mpMRI） indicated solid prostatic nodules，clinical stage T4N1Mx；initial prostate specific antigen （PSA） was 1.2 ng/mL；6868Ga-prostate specific membrane antigen PET/CT （68Ga-PSMA PET/CT） suggested abnormal uptake of nuclear lesions in the prostate （SUV4.2-5.3）；biopsy results indicated invasive mucinous adenocarcinoma.After prostate and pelvic field radiotherapy + androgen deprivation therapy （ADT） + antihypertensive treatment，lesions were significantly reduced，and hematuria symptoms were relieved.In case the clinical manifestation was dysuria；initial PSA was 91.78 ng/mL；mpMRI suggested invasion of prostate mass into the bladder and clinical stage of T4N1M1b；68Ga-PSMA PET/CT indicated prostate and pelvic lymph nodes，and multiple bone lesions showed increased nuclide uptake；biopsy results indicated prostate adenocarcinoma with mucinous adenocarcinoma.Initial endocrine treatment was performed.After 3 months，PSA was reduced to 0.083 ng/mL，and imaging showed the tumor was significantly reduced.Robotic-assisted laparoscopic tumor prostatectomy with extended pelvic lymph node dissection was performed，and endocrine adjuvant therapy was continued after surgery.Conclusion Prostate mucosa adenocarcinoma has different clinicopathological characteristics and prognosis from conventional acinar adenocarcinoma，and the whole-process management under MDT mode is of great value in the diagnosis and treatment of this disease.

KEY WORDS：prostate cancer；mucosa adenocarcinoma；full-process management;multidisciplinary diagnosis and treatment mode；endocrine treatment；robotic-assisted laparoscopic surgery；cytoreductive prostatectomy

摘要：目的 探讨多学科诊疗模式（MDT）下前列腺黏液腺癌的临床表现、病理特征及全程化治疗策略。（剩余7923字）