原发性膀胱腺癌26例临床病理分析

目的 探讨原发性膀胱腺癌的临床病理特征、诊断及鉴别诊断。方法 对26例确诊原发性膀胱腺癌进行HE、组织化学和免疫组化染色标记。结果 原发性膀胱腺癌的细胞形态、组织结构与其它部位腺癌极其相似，黏液组化及免疫组化染色显示半数以上的肿瘤具有胃肠癌的分化特征。免疫表型：CK7强阳性(18／26)，CK20弱阳性(14／26)，PSAP阳性(10／26)，CEA阳性(21／26)，CA19-9阳性(12／26)，PSA阴性。结论 膀胱原发性腺癌与膀胱转移性腺癌具有相似的组织学形态，诊断时需排除其它部位腺癌，PSAP、PSA、CK7、CK20标记对鉴别诊断具有重要参考价值。

Primary adenocarcinoma of the urinary bladder: a clinicopathological study of 26 cases

Purpose To investigate the clinicopathological characteristics,diagnosis and differential diagnosis of primary adenocarcinoma of the urinary bladder (PAUB). Methods Twenty-six tumor samples,which were diagnosed as PAUB,were obtained from surgical specimens. The sections were stained with routine HE and immunohistochemical methods. Results Cytopathological features and morphology of PAUB were similar to secondary adenocarcinoma of the urinary bladder or other adenocarcinomas. Immunostaining revealed that more than 50% of PAUB had intestinal differentiation. Immunohistochemical results showed that 18 of 26 (69%) cases stained strongly with antibody to CK7,14 of 26 (54%) positive for CK20,10 of 26 (38%) positive for PSAP,21 of 26 (80%) for CEA and 12 of 26 (46%) also positive for CA19-9. Immunostaining for PSA was negative in all the cases. Conclusions Both PAUB and secondary adenocarcinoma have shown a similar morphology. Therefore,diagnosis of PAUB should exclude other adenocarcinomas. The immunostaining for CK7,CK20,PASP and PSA is useful for the differential diagnosis of PAUB.