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1、DavidSherGillianLieberman,MDMarch2002ProstateCancer:ImaginginDiagnosisandTreatmentDavidSher,HarvardMedicalSchoolIIIGillianLieberman,MDDavidSherGillianLieberman,MDIntroduction?Theprostateglandisawalnut-sizedexocrineglandthatsurroundstheurethrabetweenthebladderneckandthegenitourinarymemb
2、rane?Itssecretionsprimarilyfunctioninsemengelation,coagulationandliquefaction–Prostaticproteinsarealsoinvolvedincoating/uncoatingthespermatozoaandininteractionswithcervicalmucus?Diseaseprocessesrangefrombenign(benignprostatichyperplasia,BPH)toinflammatory(prostatitis)tomalignant(prosta
3、tecancer)2DavidSherGillianLieberman,MDAnatomicRelationshipsAxialSagittalCoronalGray’sAnatomyOnline.http://www.bartleby.com/107/CoakleyFV,HricakH.RadiologicAnatomyoftheProstate.RadiologicClinicsNA;38(1):15-30.3DavidSherGillianLieberman,MDProstateAnatomyLobarAnatomyZonalAnatomyCoakleyFV,
4、HricakH.RadiologicAnatomyoftheProstate.RadiologicClinicsNA;38(1):15-30.4DavidSherGillianLieberman,MDProstateCancer:PresentationProstateCancerDetectedEarlyDetectedLateElevatedPSAAbnormalDREOutflowObstructionMetastaticDiseaseProstateCancerFalsePositiveProstateCancerProstateCancerIntrinsi
5、cOrganPathologyBPHAcuteChronicBPHOtherMetastaticDiseaseExtra-ProstaticGrowthBladderDiseaseBiopsyBPHUrethral/PenileDiseaseTURPChronicProstatitisMalignantExtensionAcuteUrinaryRetentionAcuteProstatitisEjaculation5DavidSherGillianLieberman,MDProstateCancer:Basics?Prostatecanceristhemostcom
6、monlydiagnosedcancerinmen(~200,000cases/year)–Lifetimeriskofdevelopingprostatecancer:16%–Riskofdyingfromprostatecancer:3.4%?Itisthe2ndleadingcauseofcancer-relatedmortalityamongmen(~40,000deaths/year)?Ingeneral,themalignancyisslow-growing,althoughtheprognosisvariesdrasticallyaccordingto
7、stage?PSAscreeninghasundoubtedlydetectedmorecancers,withadebatablesurvivalbenefit?Riskfactorsincludeolderage,blackrace(RR1.5),familyhistory(1stdegreerelativedoublesrisk)?Radiologyplaysavitalroleindiagnosisandtreatment6DavidSherGillianLieberman,MDDiagnosis?Diagnosisismadeby?Classicall
