前列腺导管腺癌42例临床病理分析.pdfVIP

· 704 · 临床与实验病理学杂志 JClinExpPathol2010Dec；26(6) 前列腺导管腺癌42例临床病理分析 刘英娜 ，蒋智铭 ，冷冬妮 ，张惠箴 ，郑 莉 ，闵 慧。 摘要：目的 探讨前列腺导管腺癌的临床病理和免疫组化特征。方法 回顾性分析42例前列腺穿刺活检、经尿道前列腺切除 和前列腺癌根治手术标本中的前列腺导管腺癌，所有病例均作 3413E12、CK5／6、p63、AMACR、PSA和PAP免疫标记，并对照 HE切片诊断。结果 导管腺癌以周围型多见(39例，92．6％)，有30例 (21．4％)合并普通经典型腺癌。镜下以大腺泡为主， 呈乳头状，筛孔状或管状结构 ，瘤细胞高柱状，核异型性明显。免疫组化表型类似经典型腺癌，但有23．8％的病例肿瘤性腺管 周围有34~E12、CK5／6、p63标记阳性的基底细胞存在。结论 导管腺癌与经典型腺癌相比，临床病理和免疫组化表现均有差 异，病理诊断应注意与高级别上皮内瘤和转移性腺癌鉴别。 关键词：前列腺肿瘤；导管腺癌；免疫组织化学 中图分类号：R737．25 文献标识码：A 文章编号：1001—7399(2010)06—0704—03 Clinicopathologicalandimmunohistochemicalfeaturesofprostateducatlad LIU Ying．na，JIANGZhi—ming ，LENGDong—ni1，ZHANGHui—zhen，ZHENGLi，MIN Hui (DepartmentofPathology，454HospitalofPLA，Nanjing 210002，China；DepartmentofPathology，Shanghai6thPeoplesHospital， ShanghaiJiaotongUniversity，Shanghai 200233，China) Abstract：Purpose Tostudytheclinicopathologicalandimmun0hist0chemicalfeaturesofprostateductal adenocarcinoma．Methods 42casesofprostateductaladenocarcinomafrom needlebiopsy，transurethralprostatectomyandradicalprostatectomyspecimenswere collected．Allcaseswereimmunostainedwith3413E12，CK5／6，p63，AMACR，PSA andPAPantibodies．TheHematoxylinandeosin stainedslidesofeachcasewerealsoreviewed．Results Mostoftheprostateductaladenocarcinomacaseswereperipheraltype(39／ 42。92．6％)．30caseswereaccompaniedbyconventionalprostateadenocarcinoma．Histologically，tumorsconsistmostlyoflargeacinar gland，presentingaspapillary，cribriform andtubularstructures．Tumorcellsshowedtallcolumnarshapeandnuclearatypia．Theimmu— nohistochemicalstainingresultsofducta1adenocarcinomaweresimilarwiththatoftheconventional adenocarcinoma，however，23．8％ of thecasesshowed34~E12，CK5／6，p63positivestainingofthebasalcells．Conclusion Therearebothclinicopath01ocalandimmuno— histochemcialdifferencesbetween the ductal carcinomaand conventionalprostate adcnocarcinoma．Prostate ductaladenocarcinoma shouldbedistinguishedfrom metastaticad andhiighgradeprostateintraepithelialneoplasm(HGPIN)． Keywords：pros