膀胱前列腺切除术中前列腺偶发癌发生率及临床病理特点分析  

Incidence and clinicopathological characteristics of incidental prostatic adenocarcinoma in radical cystoprostatectomy specimens

作　　者：沈棋[1] 胡帅[1] 李峻[1] 王静华[1] 何群[1] 

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿,男性生殖系肿瘤研究中心

出　　处：《北京大学学报（医学版）》2014年第4期515-518,共4页Journal of Peking University:Health Sciences

摘　　要：目的:分析因膀胱癌行膀胱前列腺切除术的病例中前列腺偶发癌的发生率及其临床病理特点。方法:回顾分析北京大学第一医院泌尿外科/北京大学泌尿外科研究所2005年1月至2014年3月共865例膀胱前列腺切除术(radical cystoprostatectomy,RCP)标本,所有病例术前均未发现前列腺癌(prostate cancer,PCa)。结果:865例病例中,有235例(27.2%)发现前列腺偶发癌(incidental prostate cancer,IPCa),大部分肿瘤(228/235,97.0%)局限于前列腺内(分期在pT2以内),7例(3.0%)分期为pT3。Gleason score评分84例<6分(35.7%),77例为6分(32.8%),64例为7分(27.2%),10例>7分(4.3%)。结论:本研究RCP术IPCa发生率为27.2%,大部分前列腺偶发癌病例局限于前列腺内且Gleason score评分≤7分,临床病理诊断时充分取材可以提高前列腺偶发癌检出率。Objective：To analyze the incidence and clinicopathological features of incidental prostate cancer （IPCa） in specimens from radical cystoprostatectomy （RCP） for bladder cancer. Methods： We retrospectively reviewed the histopathologieal features of 865 male patients who underwent an RCP be- tween January 2005 and March 2014. No patients had preoperative clinical or biological suspicion of prostate cancer （PCa）. Results： Among the 865 specimens, IPCa was diagnosed in 235 patients （27.2%）. Most tumors （228/235, 97.0% ） were organ-confined （pq-2） ; And 7 cases （3.0 % ） of them were diagnosed at T3. Gleason score was 〈 6 in 84 cases （35.7 % ）, 6 in 77 cases （32.8%）, 7 in 64 cases （27.2 % ）, and 〉 7 in 10 cases （4.3 % ）. Conclusion： The rate of incidentally diagnosed IPCa was 8.5% , and that in RCP and TURP specimens was 19.5% and 4.4% respectively. The majori- ty of these IPCas were organ-confined. Gleason score in most of these specimens was 〈 7. Moreover, prostate examination in the RCP specimen should be careful and sufficient, whole-amount prostate sec- tions improve diagnostic accuracy.

关 键 词：前列腺肿瘤 膀胱切除术 前列腺切除术 肿瘤分级 膀胱癌 

分 类 号：R737.25[医药卫生—肿瘤]