What are the conditions that have symptoms similar to prostate cancer?
Prostate cancer is a disease of the elderly, and most prostate cancers occur in the posterior lobe of the prostate, which may be related to the decline in the secretion of androgens in the elderly, and the atrophy of the posterior lobe of the prostate is the most obvious. According to many domestic and foreign reports, the incidence of prostate cancer is significantly positively correlated with the age of patients.
The incidence of adenocarcinoma in the autopsy of men over 50 years old in the United States is 12% 46, and the older the age, the higher the incidence, but only a small number of patients have clinical symptoms, and many clinical diseases are similar to the symptoms of prostate cancer, so it is very important to do a good job in the differential diagnosis of prostate diseases.
First of all, prostate-specific antigen (T-PSA) is a serine protease with a molecular weight of 33000 34000 produced and secreted only by prostate epithelial cells, which has good tissue specificity and can be significantly elevated in the serum of prostate cancer (PCA) patients, and has been widely used as a prostate tumor marker for early diagnosis of prostate cancer. However, some patients with prostatic hyperplasia (BPH) may also have elevated serum T-PSA.
In recent years, studies have found that a small amount of unbound PSA in serum is called free PSA (F-PSA), and its proportion is of great significance for distinguishing BPH from PCA.
Moderate to severe prostatic intraepithelial tumors: increased glandular epithelial layer, crowded nuclei, mild to significant atypia; The multilayered glandular epithelial cells of the hyperplastic glands form abrupt clusters (plexiforms) or papillae with fibrovascular sacs protrude into the dilated glandular cavity and may form clusters; The basal cell layer remains, and the basement membrane is not damaged. The nucleus has varying degrees of interchange, and the nucleoli are not large.
Prostatitis: see diffuse chronic inflammatory cell infiltration with compressed changes in the glandular and ductal epithelium. The digital rectal gland may enlarge in prostate infection, but not in the middle lobe in prostaginitis, and there are often abnormal changes such as pus cells in the prostatic fluid.
BPH and prostate cancer are considered to be separate diseases that originate in different parts of the country and may have separate pathologies. However, from an epidemiological point of view, the incidence of prostate cancer in Europe and the United States, which have a high incidence of BPH, is also high; Surveys have shown that dietary habits are a common factor in the development of BPH and prostate cancer; From a biochemical point of view, the occurrence and development of BPH and prostate adenocarcinoma are related to androgens, and they have common phenogens. However, clinical prostate cancer85 occurs in the posterior lobes of the peripheral band of the prostate or in the lateral lobes close to the capsule, whereas BPH occurs in the periurethral glands above the mons.
From the pathological manifestations, BPH manifested different degrees of adenocyst hyperplasia, glandular epithelial papillary hyperplasia, and smooth muscle fiber hyperplasia without morphological changes. Ultrastructural studies have also shown that BPH has only quantitative features and no changes in gland morphology, while prostate cancer shows ultrastructural changes to malignant manifestations, indicating that BPH is not a disease related to prostate cancer.
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