粗针4区11点穿刺诊断前列腺癌临床病理研究

目的探讨4区11点粗针穿刺（needle core biopsy,NCB）前列腺组织诊断前列腺癌的临床病理特证,Gl-eason分级,免疫表型特点及鉴别诊断。方法对138例临床疑似前列腺癌患者行粗针4区11点穿刺取活检,进行组织病理学观察及免疫组化Envision两步法检测前列腺特异性抗原（PSA）、高分子细胞角蛋白（CK34βE12）、P63、α-甲酰基-辅酶A消旋酶（P504S）表达。结果 138例穿刺标本中,84例为前列腺增生,8例伴慢性前列腺炎;前列腺低级别上皮内瘤（LGPIN）6例;前列腺高级别上皮内瘤（HGPIN）4例;筛检43例前列腺癌,其中高分化4例,中分化29例,低分化10例;1例前列腺间叶源性肉瘤。免疫组化结果：前列腺癌基底细胞消失,CK34βE12、P63为阴性;前列腺增生症,LGPIN,HGPIN和前列腺癌中PSA表达率分别为90.5%、83.3%、100%、86.0%,前列腺各种病变表达率差异无统计学意义（P〉0.05）,而P504S表达率分别为5.9%、66.7%、75%、76.7%,前列腺增生与其它三种病变差异有统计学意义（P〈0.05）。结论前列腺4区11点穿刺诊断前列腺癌临床病理诊断准确率高,但需仔细进行病理分析并结合免疫组化诊断,还需进行准确病理分级。

Four Regions 11-core Systermic Prostate Biopsy for Diagnosis of Prostate Cancer:a Clinicopathological Study

Objective To explore the clinicopathological features,the Gleason grading,immunohistochemical features and the differential diagnosis of four region 11-core systermic prostate bispsy for diagnosis of prostate cancer.Methods 138 cases of clinically suspected prostate cancer were using four regions 11-core systermic prostate biopsy,and analyzed by means of clinicopathologic and immunohistochemistry.Results Among 138 cases,84 cases were benign prostatic hyperplasia,of which 8 cases were Chronic prostatitis acc...