Objectives According to 290 cases of prostate cancer,we try to find the diagnosis and treatment of prostate cancer status quo.Patients and Methods Review of the Shandong Provincial Hospital from May 1993 to November 2007 admission of 290 cases of prostate cancer patients with the clinical data, in accordance with in accordance with tPSA≤4ng / ml,4ng/ml＜tPSA≤10ng / ml and 10 ng/ml＜tPSA≤20ng/ml,tPSA＞20ng/ml divided into A,B,C and D group.Results The results for the 27 patients in group A(9.3%),aged 42-86 years(mean 68.4 years),tPSA for 0.09-3.7ng/ml(an average of 1.3ng/ml),prostate volume 12.2-165.1ml (average 60.7 ml).DRE positive in 14 cases,MRI had abnormal signal in 10 cases, according to China diagnosis and treatment of urological diseases Guide 2007,the 14 cases will undergo prostate biopsy,but only 10 actually puncture and all of the results were positive.DRE negative 13 cases,including six cases of abnormal MRI signal,in accordance with this guidance,the six cases should undergo prostate biopsy,but only two actually puncture and the results were all positive.For Gleason score＞7,4 cases should in accordance with guidelines undergo whole body bone imaging,but the actually only 2. Overall,group A DRE positive rate of 51.9%,80%positive rate of MRI,and whole body bone imaging transfer rate of 69.2%.T_(1-2)N_0M_0 14 cases,of which only 3 cases underwent radical prostatectomy and anti-androgen therapy,and 4 underwent surgical castration and anti-androgen treatment.T_(3-4)N_0M_0 or T_(1-4)N_0M_1 or T_(1-4)N_1M_0 13 cases,of which 10 underwent surgical castration and anti-androgen treatment.Group B 18 cases(6.2%),aged 49-89 years(mean 69.9 years),tPSA 4.67-9.95ng/ ml(an average of 7.8 nag/ml),and prostate volume 14.0-234.8 ml(mean 68.1 ml).DRE positive in 14 cases,in accordance with the guidelines,all of them underwent prostate biopsy and the results were all positive.DRE negative four cases,3 of abnormal MRI signal or PSAD＞0.15,and they should be held prostate biopsy,but only 1 practiced puncture and positive results.Gleason score＞7,5 cases should undergo systemic bone scan,but only four did.Overall,group B DRE positive rate of 77.8%,the positive rate of MRI diagnosis of 93.3%,whole body bone imaging showed bone metastasis rate of 46.2%.T_(1-2)N_0M_0 8 cases,of which only 2 cases underwent radical prostatectomy and anti-androgen therapy,5 surgical castration and anti-androgen treatment.T_(3-4)N_0M_0 or T_(1-4)N_0M_0 or T_(1-4)N_1M_010 cases,of which 1 underwent radical prostatectomy and anti-androgen therapy,7 underwent surgical castration and anti-androgen therapy.Group C of 20 cases(6.9%),aged 46-84 years(mean 70.2 years),tPSA for 10.4-19.7ng/ml(mean 14.6ng/ml),prostate volume 19.8-121.8 ml(average 52.3 ml).20 patients in the guidelines should be to prostate biopsy,but only 16 did,of which 14 were positive results.Gleason score＞7 for 3 cases,including 2 cases in accordance with the Guide should undergo whole body bone scan.On the whole,Group C DRE positive rate of 50%,MRI diagnosis positive rate was 66.7%,whole body bone imaging showed bone metastasis rate of 25 per cent.T_(1-2)N_0M_0 12 cases,of which only 2 cases underwent radical prostatectomy and anti-androgen therapy,7 underwent surgical castration and anti-androgen treatment.T_(3-4)N_0M_0 or T_(1-4)N_0M_1或T_(1-4)N_0M_0 10 cases,of which 1 underwent radical prostatectomy and anti-androgen therapy,6 underwent surgical castration and anti-androgen treatment.Group D 225 cases(77.6%),aged 44-94 years(mean 70.9 years),tPSA for 20.5-341.6ng/ml(an average of 83.Sng/ml),prostate volume 7.2-520 ml(average 73.8 ml).225 cases of patients in the guidelines should be to undergo prostate biopsy,but only 176 did,and 169 cases of positive results.Gleason score＞7 in 33 cases,of which 30 cases underwent whole body bone scan.On the whole,Group D DRE positive rate of 78.3%,the positive rate of MRI diagnosis of 87.9%,whole body bone imaging showed bone metastasis rate of 64.2%.T_(1-2)N_0M_0 77 cases,of which only 18 cases underwent radical prostatectomy and anti-androgen therapy,39 underwent surgical castration and anti-androgen treatment.T_(3-4)N_0M_0 or T_(1-4)N_0M_0 or T_(1-4)N_1M_0 were 148 cases,of which 7 cases underwent radical prostatectomy and anti-androgen therapy,115 underwent castration and anti-androgen therapy.Conclusion There is not a small gap between current level of the diagnosis and treatment and the standard of China diagnosis and treatment of urological diseases Guide 2007.Seen in the following aspects:1.Positive digital rectal examination or MRI revealed abnormal signal,no matter how many tPSA value should be to prostate biopsy.Study found that the implementation of the two rates were 81.0%and 80.3%.2.tPSA＞20ng/ml or Gleason score＞7,in the case of whole body bone scan will help to accurately determine the clinical stage of prostate cancer.Study found that the implementation of the two rates were 63.5%and 84.4%.3.FPSA and tPSA at the same time as conventional detection should be practiced.Most studies show that fPSA is to raise the level of tPSA in the gray area of the prostate cancer detection rate of the effective method.However,in practice we only focus on the detection tPSA,fPSA few applications.4.Perhaps because the sense of doctors and patients cope with the problem,the guide introduced by the chemotherapy and radiotherapy,we actually rarely use. Prostate cancer patients with early diagnosis of the current situation is not optimistic,the majority of patients had a diagnosis of invasive or distant metastasis(61.7%),therefore, the current main treatment of prostate cancer is surgical castration method for drug and anti-androgen treatment.To improve the early prostate cancer diagnosis rate,we propose tPSA,fPSA and DRE,such as the joint application.The good news is that the diagnosis and treatment of prostate cancer is the rapid improvement in the status quo.The study found that,prior to 2000,only four of radical prostatectomy(11.8%),2000-2003 the introduction of radical prostatectomy for the nine cases(26.5%),after 2003 the implementation of radical operation reached 21 cases(61.8%).

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