【摘要】 目的 :结合病理复查结果 ,监测前列腺癌根治术后早期的前列腺特异抗原 (PSA)水平 ,指导术后的进一步治疗。方法 :对 2 5例前列腺癌根治术患者于术后 1、2、4周时测定PSA水平 ,尔后每个月测定一次 ,随访 5～ 17个月 ,平均 11个月 ;并对术后标本的手术切缘及包膜浸润程度行病理复查。结果 :病理报告T1～T2 期 17例 ,15例获根治 ,PSA水平均降至 0 .2 μg/L以下 ,随访 12个月无复发 ;2例PSA一直未降至正常 ,2个月后复升高而加用辅助治疗 ,其病理观察发现手术切缘有肿瘤残留。T3a或T3b期 8例 ,4例获根治 ,PSA在 3个月内降至 0 .2μg/L以下 ,随访 9个月无复发 ,病理特征为肿瘤浸润包膜但未穿透 ;4例在 1个月后因PSA回升分别加用辅助治疗 ,病理示肿瘤均穿透包膜。结论 :T1～T2 期患者 ,因手术切缘残留等原因 ,肿瘤可能早期复发 ;T3 期患者 ,特别是那些侵犯包膜但未穿透者 ,手术可能达到根治 ,并可以延迟应用雄激素阻断治疗 ,延长治疗的有效时间更多还原

【Abstract】 Purpose:To observe serum PSA changes after radical prostatectomy to guide the next step therapy. Methods:PSA values of 28 patients were measured at 1 week, 2 week, 4 week and then at every month respectively after radical prostatectomy.All cases were followed up,the median is 11 months. Results:Among 17 patients of stages T 1-T 2,15 were cured biochemically and 2 received medicines for androgen blockage because of elevated PSA levels 2 months after radical prostatectomy.Of 8 cases of stage T 3a or T 3b ,4 were cured biochemically during the following period.Conclusions:Stages T 1-T 2 patients of prostate carcinoma can reoccur probably due to positive margin and patients of stage T 3 can also have the chance to be cured,especially for carcinoma invading into ,but not through prostate capsule.更多还原