Prostate cancer is easily confused with 5 diseases. What tests can be used to distinguish them?

Prostate cancer is common in men over 50 years old, with very few young people or children. More than 95% of patients are adenocarcinomas, and the rest are transitional cell carcinomas, squamous cell carcinomas, and sarcomas. Prostate cancer occurs from the alveoli and ducts, often originating from the peripheral zone and rarely in the central area. Prostate cancer often has multiple lesions, with a single nodule accounting for less than 10%.

Prostate cancer diagnosis should be distinguished from five diseases:

1. Differentiation from prostatic hyperplasia

The two are generally easy to distinguish. However, in the hyperplastic prostate glands, the epithelial cells in some areas are atypical in morphology and can be mistaken for cancer. The key points of the difference are: the alveoli in the hyperplastic glands are larger, the surrounding collagen fiber layer is intact, the epithelium is double-layered and high-column, the cell nucleus is smaller than that of prostate cancer patients and is located at the base of the cell, and the glands are arranged regularly to form obvious nodules.

2. Differentiation from prostate atrophy

Prostate cancer often starts from the atrophic part of the gland, so it should be carefully identified. Atrophic alveoli are sometimes tightly clustered, atrophic and smaller, and the epithelial cells are cubic with large nuclei, which looks very much like cancer. However, this type of atrophy often involves the entire lobule, the collagen connective tissue layer is still intact, the matrix is ​​not invaded, but it itself is sclerotic and atrophic.

3. Differentiation from prostatic squamous epithelium or transitional epithelium metaplasia

It often occurs in the healing part of the infarct area within the gland, with well-differentiated squamous epithelium or transitional epithelium without degeneration or split phase. The most prominent feature of metaplasia is ischemic necrosis or fibrous connective tissue matrix lacking smooth muscle.

4. Granulomatous prostatitis

The cells are large and can aggregate into sheets. They have transparent or light red stained cytoplasm and small vesicular nuclei, which are very similar to prostate cancer, but are actually macrophages. Another type of cells are polymorphic, with condensed and vacuolated nuclei, small in size, arranged in rows or clusters, and sometimes some acini can be seen. When distinguishing, it should be noted that granulomatous prostatitis rarely forms acini, and the relationship between the lesions and normal glandular ducts remains unchanged. Degenerative amyloid bodies and multinucleated giant cells are often seen. The cells of prostate cancer are low columnar or cubic, with clear cell walls, dense eosinophilic cytoplasm, larger nuclei than normal, and may have variations in staining and morphology, and inactive division. Its acini are small, lack of convoluted tubules, and completely lose their normal arrangement morphology. They infiltrate irregularly into the matrix, and the collagen connective tissue layer no longer exists. The acini contain a small amount of secretions, but rarely amyloid bodies. If prostate cancer undergoes obvious degeneration, the tissue structure will completely disappear, and there will be no tendency for acini to form.

5. Prostate cancer should be differentiated from prostate tuberculosis and prostate stones.

Yes, the diagnosis of prostate cancer should be distinguished from the five diseases. It seems that the diagnosis of prostate cancer is crucial. Early correct diagnosis and early treatment can keep you away from the pain of prostate cancer.

Three recommended diagnostic methods for prostate cancer

When men have prostate cancer, they need to undergo a rectal digital examination, which is the main method for diagnosing early prostate cancer. Since the prostate is close to the front of the rectum, the size and texture of the prostate can be felt through a rectal digital examination. The normal prostate gland is about 4 cm by 3 cm in size, with a soft texture, a smooth surface without nodules, and symmetrical lobes on both sides. When a patient has prostate hyperplasia, the doctor can find changes in his prostate gland through a rectal digital examination.

Men with prostate cancer need to undergo serum prostate-specific antigen testing, which is currently the most sensitive marker for prostate cancer. Although prostate-specific antigen can also be detected in the blood of normal people, when serum prostate-specific antigen rises to a certain value, it indicates that cancer cells exist in the patient's prostate.

What are the diagnostic methods for prostate cancer? Men with prostate cancer can undergo transrectal ultrasound examinations. Through transrectal ultrasound examinations, doctors can find out whether there are nodules in the patient's prostate. When nodules appear in the prostate, but the nodules are small or grow inside the gland, they are often not felt through rectal examinations. However, transrectal ultrasound examinations can detect such abnormal nodules, allowing prostate cancer to be discovered early.