医学ppt课件前列腺癌的诊断与治疗.pptVIP

1 講者 　Presenters: 歐永恒醫生（伊利沙伯醫院外科部泌尿外科顧問醫生；香港腔 內微創泌尿外科學會會長） 何立言醫生（外科部副顧問醫生） 陳偉希醫生（外科部泌尿外科顧問醫生） 張寬耀醫生（臨床腫瘤科副顧問醫生） 　Dr AU Wing-hang (Consultant Urologist, Department of Surgery, QEH; President, The Hong Kong Society of Endourology) 　Dr Ho Lap-yin (Associate Consultant, Department of Surgery) Dr Steve Chan Wai-hee (Consultant Urologist, Department of Surgery) Dr Cheung Foon-yiu (Associate Consultant, Department of Clinical Oncology) 1 前列腺癌在香港的情況Prostate Cancer in Hong Kong 2 診斷　Diagnosis 徵狀Symptoms 指診Digital rectal examination (DRE) 前列腺特殊抗原Serum Prostate-specific antigen (PSA) 經肛門超聲波引導前列腺活檢Transrectal Ultrasound(TRUS)-guided prostate biopsy 3 徵狀 Symptoms 早期Early 大多沒有徵狀Mostly asymptomatic 因下泌尿道徵狀求診時確診Case-finding on consultation for lower urinary tract symptoms 晚期Advanced 局部癌腫浸潤、擴散至淋巴腺、擴散至骨Local invasion, lymph node metastasis, bone metastasis 嚴重骨痛、排尿困難、輸尿管阻塞引至腎衰竭、脊髓受壓引至下半身癱瘓Bone pain, obstructive uropathy, cord compression 指診　Digital rectal examination (DRE) 前列腺指診DRE of prostate 結節 / 硬塊Hard nodule / induration 清除中槽 Obliteration of median groove 懷疑損傷Suspicious lesion on DRE 前列腺活檢的絕對適應症Absolute indication for prostate biopsy 前列腺特殊抗原Serum Prostate-specific antigen (PSA) 驗血Blood test 前列腺特殊性（並非前列腺癌特殊性）Organ-specific, NOT cancer specific 前列腺癌早期檢測Case-finding for early prostate cancer 療效跟進Monitoring of treatment response 經肛門超聲波引導前列腺活檢(1)Transrectal Ultrasound(TRUS)-guided Prostate Biopsy (1) 管針切片法Systemic biopsy (12-cores) 經肛門超聲波引導前列腺活檢(2) Transrectal Ultrasound(TRUS)-guided Prostate Biopsy (2) 日間檢查、無須留院 Day procedure 治療Treatment Active surveillance 積極觀察 Radical surgery 根治性手術 Radiotherapy 放射治療 Hormonal therapy 激素治療 Chemotherapy 化療 Multi-disciplinary Management of Prostate Cancer 前列腺癌多元綜合治療 9 香港市民對前列腺癌的認知調查Prostate Cancer Awareness Campaign 伊利沙伯醫院外科部泌尿外科組 及 香港腔內微創泌尿外科學會協辦 Jointly organized by Division of Urology, Department of Surgery Queen Elizabeth Hospital The Hong Kong Society of Endourology The Hong Kong Society of Endourology 樣本資料 訪問日期： 2010年11