108例前列腺癌根治标本全器官取材的临床病理学观察  

Clinicopathologic study of processing completely embedded radical prostatectomy specimens

作　　者：肖立[1] 殷于磊[1] 陈燕[1] 卢晨[1] 余波[1] 

机构地区：[1]复旦大学附属华东医院病理科,上海200040

出　　处：《临床与实验病理学杂志》2014年第11期1251-1255,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的应用前列腺癌根治术标本的全器官取材方法观察前列腺癌的临床病理学特征。方法系统性全器官取材前列腺癌根治标本108例,并复习相关临床病理资料。结果患者年龄55-80岁（平均68.1岁）,术前血清PSA平均值18.3μg/ml。病理分期：p T2期59例（54.6%,59/108）,其中14例为p T2a期（23.7%,14/59）,5例为p T2b期（8.5%,5/59）,40例为p T2c期（67.8%,40/59）;p T3期49例（45.4%,49/108）;p T3a期29例（59.2%,29/49）,其中p T3b期20例（40.8%,20/49）。84例同时送检盆腔淋巴结,3例可见淋巴结转移（转移率3.6%）。Gleason评分：9例≤6分（8.3%）,66例为7分（61.1%）,33例≥8分（占30.6%）。29例存在Gleason 5生长方式。切缘状况：28例（25.9%）呈切缘阳性,21例为p T3期（75%）,15例（53.6%）存在Gleason 5生长方式。术前活检与术后病理分期比较：p T2期肿瘤术前PSA平均值14.00μg/ml,肿瘤累及针数≤2针者占68.5%,〉5针者占4.3%;p T3期肿瘤术前PSA平均值23.82μg/ml,肿瘤累及针数≤2针者占19.6%,〉5针者占28.3%。p T2期与p T3期肿瘤活检累及针数差异有统计学意义（P〈0.01）。术前活检指标在Gleason 6分者81.3%根治标本上升为7分或以上。结论要获得准确的病理分期、分级及切缘状况评估需全器官系统化取材前列腺癌根治标本。PSA水平、Gleason评分、肿瘤累及针数是前列腺癌术前临床分期和危险度评估的良好指标。Purpose To study clinicopathologic feature of prostate cancer by complete embedding of radical prostatectomy specimen.Methods 108 cases of radical prostatectomy by systematic whole organ embedding were reviewed. Results The patient age ranged from 55 to 80 years（ mean 68. 1 years）. The preoperative average PSA value was 18. 3 μg / ml. 59 cases（ accounting for 54. 6% of all prostatectomy cases） were in p T2 stage,while 23. 7%（ 14 /59） in p T2 a stage,8. 5%（ 5 /59） in p T2 b,and 67. 8%（ 40 /59） in p T2 c. 49 cases（ 45. 4%） in p T3 stage,while 59. 2%（ 29 /49） in p T3 a,40. 8%（ 20 /49） in p T3 b. 3. 6%（ 3 /84） cases presented pelvic lymph node metastasis. 8. 3%（ 9 /108） cases were graded as Gleason Score 6 or less,61. 1% Gleason Score 7,30. 6%（ 33 /108） Gleason Score 8 or more. Gleason Pattern 5 component was found in 26. 9%（ 29 /108） cases. Positive margin was observed in25. 9%（ 28 /108） cases,with 75%（ 21 /28） in p T3 stage and 53. 6%（ 15 /28） having Gleason Pattern 5. Patient in p T2 stage presented mean PSA value of 14. 00 μg / ml,involved in no more than 2 biopsy cores in 68. 5% cases,and more than 5 cores in 4. 3%,while in p T3 stage,presented mean PSA value of 23. 82 μg / ml,involved in no more than 2 cores in 19. 6%,and more than 5 cores in28. 3%. The difference of involved core number was significant in p T2 and p T3 tumors（ P 0. 01）. 81. 3% cases graded Gleason Score 6 in biopsy was assigned to Gleason Score 7 or more in prostatectomy. Conclusions Completely sampling radical prostatectomy specimen should be recommended for accurate staging and margin status. Preoperative PSA value,Gleason Score of biopsy,involved core number by cancer is a still helpful parameter for clinical staging and risk estimate.

关 键 词：前列腺肿瘤 根治 临床 分期 

分 类 号：R737.25[医药卫生—肿瘤]