How to detect prostate cancer

Prostate cancer refers to an epithelial cell malignant tumor that occurs in the male prostate. In 2004, WHO's "Pathology and Genetics of Tumors of the Urinary System and Male Reproductive Organs" classified prostate cancer pathologically into adenocarcinoma (acinar adenocarcinoma), tubular adenocarcinoma, urothelial carcinoma, squamous carcinoma, and adenosquamous carcinoma. Among them, male prostate adenocarcinoma accounts for more than 95%.

Therefore, the prostate cancer we usually refer to is male prostate adenocarcinoma. In 2012, the prevalence of prostate cancer in the tumor-registered areas of my country was 9.92/100,000, ranking sixth among the prevalence of malignant tumors in men. The age of onset is relatively low before the age of 55, and gradually increases after the age of 55. The prevalence increases with age, and the peak age is 70-80 years old. Patients with familial hereditary prostate cancer develop at an earlier age, and patients aged ≤55 years account for 43%.

Examination items: B-ultrasound, radionuclide bone scan, CT, male prostate puncture biopsy

Laboratory inspection

The prostate-specific antigen (PSA) level of men with low-grade blood cells increases, but in about 30% of patients, the PSA level may not increase, but only fluctuate within the normal range (normal range <4.0ng/ml). If PSA measurement is combined with direct rectal examination (DRE), the diagnostic rate will be significantly improved.

Increased blood pressure blood cell acid phosphatase is related to prostate cancer metastasis, but lacks specificity. In recent years, radioimmunoassay can improve its specificity. Male prostate acid phosphatase monoclonal antibody and male prostate antigen measurement need to improve their specificity. 20% to 70% of stage C prostate cancer have increased acid phosphatase, and it also increases with cancer metastasis. If it continues to increase, there is no doubt that there is bone metastasis. Blood cell acid phosphatase, male prostate acid phosphatase increase will decrease after surgery, which is a representative of a good prognosis. The prostate acid phosphatase in the outer membrane is metabolized by the prostate cells and metabolized through the prostate vessels. In prostate cancer, the acid phosphatase produced by the tumor cells has no way to be excreted through the vessels or the vessels are blocked by cancer, and the enzyme is absorbed into the blood circulation, resulting in an increase in acid phosphatase.

Diagnostic imaging examination

1. Ultrasound examination can detect low-echo nodules in the prostate, but they must be distinguished from inflammation or stones.

2. Radionuclide bone scans can often show early signs of metastatic disease compared to X-rays.

3. CT or MRI examination can show changes in the shape of the prostate, tumors and metastasis. The key CT manifestations of prostate cancer are that when the scanner is raised, the cancer lesions show a low-density area that is not significantly increased, the capsule shows irregular information, the fat around the glandular duct disappears, and when the seminal vesicle is damaged, the seminal vesicle boundary is blurred, the bladder seminal vesicle angle disappears or the seminal vesicle is enlarged; when the tumor invades the bladder or the organs around the prostate, the pelvic CT can show corresponding changes. When there is tumor metastasis in the pelvic lymph nodes, CT can judge whether there is metastasis based on the changes in the size of the pelvic lymph nodes.

The key to MRI examination of prostate cancer is to use T2 weighted calculation coding sequence. On T2 weighted calculation images, if a low-signal damaged area appears within the high-signal male prostate cervical venous band, such as the destruction of the strip-like structure of the male prostate band, or the fading of the boundary between the cervical venous band and the central band, prostate cancer should be considered.

4. Male prostate biopsy can be used as a way to diagnose prostate cancer. Failure to remove tumor tissue by puncture cannot deny the diagnosis.

Increased blood cell acid phosphatase is associated with prostate cancer metastasis, but lacks specificity. In recent years, radioimmunoassay has been used to improve its specificity. Male prostate acid phosphatase monoclonal antibodies and male prostate antigen measurements need to improve their specificity. 20% to 70% of stage C prostate cancers have increased acid phosphatase, which also increases with cancer metastasis. If it continues to increase, there is no doubt that there is bone metastasis. Blood cell acid phosphatase, male prostate acid phosphatase increases will decrease after surgery, which is a representative of a good prognosis. The prostate acid phosphatase in the outer membrane is metabolized by the prostate cells and metabolized through the prostate vessels. In prostate cancer, the acid phosphatase produced by the tumor cells has no way to be excreted through the vessels or the vessels are blocked by cancer, and the enzyme is absorbed into the blood circulation, resulting in an increase in acid phosphatase.