最后审阅: 19 九月 2021
最后更新: 29 四月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 前列腺特异性抗原 (PSA) 升高

其他诊断因素

  • 直肠指检(DRE)结果异常
  • 夜尿
  • 尿频
  • 排尿犹豫
  • 排尿困难
  • 血尿
  • 体重减轻或厌食症
  • 昏睡
  • 骨痛
  • 可触及的淋巴结

危险因素

  • 50 岁以上
  • 黑人
  • 欧洲西北部、加勒比地区、澳大利亚、新西兰、北美和南非人群
  • 阳性家族史/遗传因素
  • 膳食脂肪含量高

诊断性检查

首要检查

  • 血清前列腺特异性抗原 (PSA)
  • 睾酮
  • 肝功能检查 (LFT)
  • 全血细胞计数(FBC)
  • 肾功能
  • 前列腺活组织检查

需考虑的检查

  • 骨扫描
  • X线平片
  • 盆腔 CT 扫描
  • 盆腔 MRI/直肠内 MRI

新兴检查

  • 遗传生物标志物
  • 18F-氟化钠 PET/CT 和 11C-胆碱 PET/CT
  • 前列腺癌抗原 3 (PCA3) 检测
  • TMPRSS2-ERG 融合基因
  • 前列腺健康指数 (PHI)
  • 4K 评分试验

治疗流程

撰稿人

作者

Timothy J. Wallace, MD, PhD

Radiation Oncologist

Department of Radiation Oncology

Virginia Commonwealth University

Richmond

VA

利益声明

TJW declares that he is the principal investigator of an R-21 NIH research grant investigating the tumour-mediated immune responses in African-American men with prostate cancer.

Mitchell S. Anscher, MD, FACR, FACRO, FASTRO

Professor Emeritus

Department of Radiation Oncology

Virginia Commonwealth University

Richmond

VA

利益声明

MSA declares that he has no competing interests.

同行评议者

Emma Alexander, MBBS

Clinical Oncology Registrar

St Luke's Cancer Centre

Royal Surrey Hospital

Guildford

Surrey

UK

利益声明

EA has received consultation fees from the following organisations: Blue Cross/Blue Shield Association, Sanofi-Aventis, Ferring Pharmaceuticals, Pfizer Corporation, American Urological Association, National Institutes of Health, Accreditation Council for Graduate Medical Education, Royal Hallamshire Hospital, Hartford County Medical Association. EA owns shares in Pfizer Pharmaceuticals, Johnson and Johnson, and General Electric Corporation.

Peter Albertsen, MD

Medical Director

UConn Medical Group

University of Connecticut Health Center

Farmington

CT

利益声明

PA declares that he has no competing interests.

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