前列腺基底细胞癌临床病理特征及文献复习  

Clinicopathological features and literature review of prostate basal cell carcinoma

作　　者：申发燕[1] 白冬雨[1] 张海萍[1] 钟山[1] 庄严阵[1] Shen Fayan;Bai Dongyu;Zhang Haiping;Zhong Shan;Zhuang Yanzhen(Department of Pathology,the First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]厦门大学附属第一医院病理科,厦门361003

出　　处：《中国组织化学与细胞化学杂志》2020年第1期56-60,共5页Chinese Journal of Histochemistry and Cytochemistry

摘　　要：目的探讨前列腺基底细胞癌(basal cell carcinoma,BCC)的临床特征、病理特点、治疗方法及相关预后,并对相关文献进行复习。方法回顾性分析3例前列腺基底细胞癌的临床特征、病理特点及相关免疫组织化学表型。结果前列腺基底细胞癌男性老年患者多见,临床上常出现尿路梗阻的症状,表现为排尿不尽、尿频、尿急、尿痛等,血清学检查前列腺特异性抗原(prostate specific antigen,PSA)水平在正常范围之内,镜下见肿瘤细胞大多呈巢团状、腺样及腺样囊性结构,外围的瘤细胞可呈栅栏状排列,部分癌巢中心可见坏死,部分腔内可见分泌物。免疫组织化学染色显示,(3/3例)p63、CK5/6及BLC-2大部分细胞呈阳性,但位于最内层的腺腔样细胞阴性,(3/3例)CK7部分细胞阳性,主要是最内层的管腔样细胞阳性,1例行GATA-3、Ber-EP4检测部分肿瘤细胞阳性,(3/3例)肿瘤细胞P504s、PAS、CK20、S-100、CD117阴性,3例Ki-67增殖指数为10%~60%,1例行HER-2检测呈阴性。3例患者均行前列腺电切术,随访6个月至3年,1例患者于术后6个月肿瘤复发死亡,其余2例患者无瘤生存。结论前列腺基底细胞癌临床非常罕见,诊断时要结合临床血清学检查、镜下形态学特点及免疫组织化学表型,该肿瘤并非完全惰性,应注意定期随访或进一步治疗。Objective To explore the clinical and pathological features, treatment and relevant prognosis of prostate basal cell carcinoma, and review related literature. Method The clinical features, pathological characteristics and related immunohistochemical phenotypes of 3 cases of prostate basal cell carcinoma were retrospectively analyzed. Result Prostate basal cell carcinoma is more common among elderly male patients. Typical clinical symptom is urinary obstruction, manifested as incomplete bladder emptying, frequent micturition and dysuria, etc. Serologic examination showed the prostate specific antigen level was within normal range, the microscopic observation showed most tumor cells were arranged in nest-like, gland-like and adenoid-cystic structure, while the peripheral tumor cells could be arranged in a palisade-like structure, part of the center of cancer nest showed visible necrosis and secretion could be found in some cell lumens. IHC staining(Immunohistochemical staining) showed that(case 3/3) p63, CK5/6 and BLC-2 were positive in most cells, but negative in the glandular-lumen-like cells which located at the innermost layer.(case 3/3) CK7 was positive in part of the cells, mainly the lumen-like cells at the innermost layer. GATA-3 and Ber-EP4 were detected in 1 case and positive in some cells.(case 3/3) P504 s, PAS, CK20, S-100 and CD117 were all negative in tumor cells. Ki-67 labelling index of 3 cases ranged from 10% to 60%, HER-2 was detected in 1 case and negative in tumor cells. All the 3 patients underwent transurethral electro-resection of the prostate and the postoperative follow-up lasted for 6 months to 3 years. 1 patient died of tumor recurrence 6 months after surgery, and the other 2 patients remained cancer-free survival. Conclusion Prostate basal cell carcinoma is rare in clinical practice. Diagnosis of the disease should be based on clinical features combined with clinical serological examination, microscopic morphological features and immunohistochemical phenotype. The tumor is not completely

关 键 词：前列腺 基底细胞癌 病理特征 免疫组织化学表型 

分 类 号：R365[医药卫生—病理学]