28例膀胱癌根治标本中伴偶发前列腺癌患者的临床及病理特征分析  

Clinical and pathological characteristics of 28 patients with incidental prostate cancer in radical cystoprostatectomy specimens

作　　者：杨旭梅 宋学刚 杨越 杨旭丹[1,3] 孙华君 YANG Xumei;SONG Xuegang;YANG Yue;YANG Xudan;SUN Huajun(Departement of Pathology,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Sichuan Chengdu 610072,China;Beijing Changping District Chinese and Western Medicine Combined Hospital,Beijing 102200,China;Department of Pathology,University of Electronic Science and Technology,Sichuan Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院病理科,四川成都610072 [2]北京市昌平区中西医结合医院,北京102200 [3]电子科技大学病理学教研室,四川成都610072

出　　处：《现代肿瘤医学》2023年第21期3992-3998,共7页Journal of Modern Oncology

基　　金：四川省干部保健科研课题(编号:川干研2021-217)。

摘　　要：目的:总结根治性膀胱前列腺切除术(radical cystoprostatectomy,RCP)标本中伴偶发前列腺癌(incidental prostate cancer,IPCa)患者的临床病理特征,讨论其预后影响因素。方法:回顾性分析2016年12月至2022年06月间在四川省人民医院接受膀胱肿瘤RCP治疗的228例术后病理示28例伴IPCa患者的临床、病理特征,并进行预后相关性因素分析。结果:在228例RCP标本中,28例(12.28%)伴有IPCa,其中10例(4.39%)为具有临床意义的前列腺癌(prostate cancer,PCa),18例(7.90%)为无临床意义的PCa。85.71%(6/7)伴有高级别前列腺尿路上皮肿瘤(high-grade prostate neoplasia,HGPIN)的患者伴IPCa。不伴IPCa组和伴IPCa组间以及有临床意义PCa组和无临床意义PCa组间在年龄、术前PSA水平、膀胱肿瘤组织类型、分期等参数无显著差异(P>0.05);伴或不伴有IPCa、IPCa的病理分级及有或无临床意义均与患者生存时间无相关性(P>0.05);膀胱癌病理分期和年龄是影响患者生存时间的主要因素(P<0.000 1,P=0.004)。结论:RCP标本中IPCa病理分级低,分期早,对患者预后无显著影响;患者预后主要取决于膀胱肿瘤的分期和患者年龄;对于局限性膀胱癌的年轻患者,仍然可推荐使用保留部分前列腺的膀胱切除术式。此外,在RCP标本中,前列腺组织中发现HGPIN应提高对IPCa的警惕。Objective:To summarize the clinicopathological features of patients with incidental prostate cancer(IPCa)in radical cystoprostatectomy(RCP)specimens and discuss the prognostic factors.Methods:The clinical and pathological features of 228 patients with bladder tumor treated by RCP in Sichuan Provincial People's Hospital from December 2016 to June 2022 were retrospectively analyzed,and the prognostic factors were analyzed.Results:28 out of 228 patients(12.28%)who underwent RCP were diagnosed IPCa.Of which 10 cases(4.39%)were diagnosed as clinically significant prostate cancer(PCa),and 18 cases(7.90%)were clinically insignificant.IPCa was found in the 85.71%(6/7)of patients with high-grade prostate neoplasia(HGPIN).There were no statistical significance in age,preoperative PSA level,bladder tumour pathological type and stage between the two groups with and without IPCa(P>0.05).There were no correlation between survival time and the patients with or without IPCa,pathological grade of IPCa and clinical significance(P>0.05).Pathological stage of bladder tumour and age were the main factor affecting the survival time of patients(P<0.0001,P=0.004).Conclusion:In RCP specimens,IPCa had low pathological grade and early stage,and had no significant effect on the prognosis of patients.The prognosis of patients mainly depended on the stage of bladder tumor and the age of patients.Partial prostatectomy was still recommended for young patients with localized bladder cancer.In addition,we should arise the alarm for IPCa when HGPIN was found in prostate tissue from RCP specimens.

关 键 词：膀胱肿瘤 膀胱前列腺切除术 偶发前列腺癌 预后 年龄 

分 类 号：R737.14[医药卫生—肿瘤]