膀胱前列腺根治性切标本偶发前列腺癌的临床病理观察  

Incidental prostatic carcinoma in radical cystoprostatectomy specimens:a clinicopathological analysis

作　　者：张云岗[1] 李青[1] 谷雨妹 赵宏颖[1] 曹勍[1] 金木兰[1] ZHANG Yun-gang;LI Qing;GU Yu-mei;ZHAO Hong-ying;CAO Qing;JIN Mu-lan(Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院病理科,北京100020

出　　处：《诊断病理学杂志》2021年第5期348-351,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨因膀胱癌行膀胱前列腺根治切除标本中偶发前列腺癌的发生率及临床病理特征。方法回顾分析我院2011—2019年243例行膀胱前列腺根治术的男性膀胱癌患者的临床资料与病理特征。前列腺取材包括全部取材或抽样取材。结果在243例标本中,发现67例(27.6%)前列腺腺癌,其中27例为具有临床意义的前列腺癌:2例<50岁;8例Gleason评分3+4分,1例4+3分,1例4+5分;1例有淋巴结转移;2例前列腺外侵犯(精囊腺及膀胱);8例切缘阳性。此外,33例(33/243,13.6%)膀胱癌侵及前列腺间质;9例前列腺癌累及尖部。伴发前列腺癌组和无前列腺癌组比较,各临床病理参数无显著差异。结论膀胱癌伴发前列腺癌的发生率为27.6%,其中部分前列腺癌具有临床意义(40.3%)。这提示临床医师审慎评估保留前列腺或前列腺尖部术式的风险性,为患者制订更加合理的治疗方案。Objective To assess the incidence and cliniopathological characteristics of incidentally diagnosed prostate carcinoma in radical cystoprostatectomy specimens for bladder cancer.Methods We retrospectively elavuated the clinical data and pathological features of 243 male patients with bladder cancer undergoing a radical cystoprostatectomy at our hospital from 2011 to 2019.Prostate spcimens were totally or partially submitted for histological examination.Results Among the 243 specimens,prostatic adenocarcinoma was detected in 67 patients(27.6%).27 cases(40.3%)were diagnosed as clinical significant disease,including 2 cases aged less than 50 years,8 cases with Gleason score 7(3+4),1 case with score 7(4+3),1 case with score 9(4+5),1 case with lymph node metastasis,2 case with extraprostatic extension(to bladder and seminal vesicle),and 8 cases with surgical margin positive.Moreover,prostate stroma invasion by bladder cancer was detected in 33 cases(33/243,13.6%),and prostate apex involvement by incidental prostate cancer in 9 cases.There was no significant difference in clinicopathological parameters between the clinically significant and insignificant cancer groups.Conclusions The rate of incidentally diagnosed prostatic adenocarcinoma in radical cystoprostatectomy is 27.6%,and some of these prostate carcinomas are significant disease,thus warranting a careful evaluation of the oncological risks on prostate-sparing or prostate apex-sparing cystectomy in order to make more reasonable treatment plan for patients.

关 键 词：膀胱前列腺根治切除术 偶发前列腺癌 膀胱癌 

分 类 号：R737.25[医药卫生—肿瘤]