以消化道症状为主要表现的5例前列腺癌诊断分析

Clinical diagnosis of prostate cancer in 5 cases with gastrointestinal symptoms

关键词:  前列腺癌  消化道症状  骨质破坏

Key words:  prostate cancer  gastrointestinal symptoms  bone destruction

摘要:

目的　探讨如何提高前列腺癌的诊断水平，减少其漏诊、误诊。方法　收集2011年1月至2015年7月5例以消化道症状为主要表现的男性前列腺癌患者的临床资料，入院前于院外存在首诊误诊，主要误诊疾病为慢性胃炎、消化道出血、肝损害。总结该5例患者的临床表现特点，并对入本院后的各项辅助检查资料进行分析。 结果　5例患者均伴有乏力、体重下降，化验有血红蛋白(HB)下降，碱性磷酸酶(ALP)明显升高，影像学检查提示有多发骨质破坏，进一步化验总前列腺特异性抗原(tPSA)明显升高，前列腺活检提示前列腺癌。 结论　有消化道症状，伴有贫血、碱性磷酸酶升高，并有多发骨质破坏的男性患者需高度警惕前列腺癌的可能。

Abstract:

Objective　To improve diagnostic level of prostate cancer, reduce missed diagnosis and misdiagnosis of the disease. Methods　Clinical data of 5 male patients with prostate cancer, who were treated in the Department of Gastroenterology the First Affiliated Hospital of Dalian Medical University between January 2011 and July 2015, were collected. All of the 5 patients had gastrointestinal symptoms as the main complaints and were misdiagnosed at first in the other hospital. The clinical manifestations and the auxiliary examination data were retrospectively analyzed. Results　All 5 patients had fatigue, weight loss, decreased hemoglobin (HB), and significantly increased alkaline phosphatase (ALP). Imaging examination indicated multiple bone destruction. Further test revealed obviously raised total prostate-specific antigen (tPSA). Prostate biopsy demonstrated prostate cancer. Conclusion　Gastrointestinal symptoms accompanied by anemia, elevated alkaline phosphatase, and multiple bone destruction in male patients need to be highly alerted for the possibility of prostate cancer.