TUR-Pにより前立腺肥大症と診断された後に発生した前立腺癌の検討

Abstract

1993年1月～5年6ヵ月間に前立腺癌と診断された319例のうち, 過去にTUR-Pにより病理組織学的にBPHと診断されていた7例について検討した.PSA高値のため受診した症例が3例で, うち1例はTUR-P前より断続してPSAが高値であった.残る4例もPSAは高値であった.TUR-Pから癌診断迄の期間は22ヵ月から15年であったが, 6例は6年以上であった

From January 1993 to June 1998, 319 cases were histopathologically diagnosed as prostatic cancer. In 7 of the 319 cases (2.2%) transurethral resection of the prostate (TUR-P) had been performed and a diagnosis of benign prostatic hyperplasia had been made with the resected specimens. The interval between TUR-P and the diagnosis of prostatic cancer ranged from 22 months to 15 years. All the cases showed an elevation of the prostate specific antigen (PSA) value (6.4-399 ng/ml, Tandem-R: RIA) at the time of cancer diagnosis. In 2 cases, PSA was measured in cancer screening. The clinical stage was stage B1 in 2 cases, stage B2 in 2 and D2 in 3. Only one case had been regularly followed-up after TUR-P, in which cancer was diagnosed by needle biopsy 22 months after TUR-P, because of the sustained high PSA values. Since most of such patients have an advanced stage of prostate cancer, it is of importance to have periodical follow-up examinations after TUR-P. The measurement of PSA appears the most reliable means in this way.