摘要
目的:分析前列腺非典型腺瘤样增生病变(AAH)的病理特征。方法:选取2016年至2017年期间成都医学院第一附属医院收治的15例AAH患者作为研究对象。分析对这些患者的病灶进行实验室检查、显微镜检查、免疫组化检查的结果。结果:这些患者进行血总前列腺特异性抗原定量检测的结果为0.13~87.51 ng/ml,其进行血游离前列腺特异抗原百分率检测的结果为5%~32%。在这些患者中,进行血总前列腺特异性抗原定量检测结果异常的患者占53.33%,进行血游离前列腺特异抗原百分率检测结果异常的患者占40%。在这些患者的非典型结节状增生区域内均可见增生的腺泡和紊乱排列的导管,腺泡与导管之间的间质减少,腺泡和导管变得拥挤。在这些患者非典型增生结节外的组织中,均可见间质增生和炎细胞浸润。这些患者的非典型结节样增生区域内腺体或导管中的PSA均呈阳性表达,其病灶中均出现部分腺体HCK、CK5/6、P63不连续表达的情况。在这些患者中,有5例患者(占33.33%)同部位少许腺体中的AMACR呈弱阳性表达,有10例患者(占66.67%)同部位少许腺体中的AMACR呈阴性表达。在这些患者中,有3例患者在进行穿刺活检术后接受前列腺切除手术。在这3例患者中,有1例患者被诊断患有前列腺腺泡腺癌(其Gleason的评分为7分),占33.33%;有2例患者被诊断患有前列腺良性增生。对这些患者进行电话随访的结果显示,其中有14例患者存活,占93.33%;有1例患者失访,占6.67%。结论:AAH患者的病灶内可见增生的腺泡和紊乱排列的导管,腺泡与导管之间的间质减少,其病灶外有间质增生和炎细胞浸润。临床上应根据进行实验室检查、显微镜检查、免疫组化检查等综合检查的结果对该病患者的病情进行诊断,以降低其病情的漏诊率和误诊率。
objective:to analyze the pathological features of prostate atypical adenomatoid hyperplasia(AAH).Methods:15 AAH patients admitted to the first affiliated hospital of chengdu medical college from 2016 to 2017 were selected as the research objects.The results of laboratory examination,microscopic examination and immunohistochemical examination of the lesions in these patients were analyzed.Results:in these patients,the results were 0.13~87.51 ng/ml for total prostate-specific antigen and 5%~32%for free prostate-specific antigen.Among these patients,53.33%had abnormal results of quantitative blood total prostate-specific antigen(psa)and 40%had abnormal results of blood free prostate-specific antigen(psa).Note the presence of proliferating acinus and disorganized ducts in these patients with atypical nodular hyperplasia.The stroma between the acinus and the ducts is reduced and the acinus and ducts become congested.Interstitial hyperplasia and inflammatory cell infiltration are seen in the tissues outside the atypical hyperplastic nodules in these patients.In these patients,PSA was positively expressed in the glands or ducts in the area of atypical nodular hyperplasia,and discontinuous expressions of HCK,ck5/6 and P63 were observed in some glands in the lesions.Among these patients,5 patients(33.33%)showed weak positive expression of AMACR in a few glands at the same site,and 10 patients(66.67%)showed negative expression of AMACR in a few glands at the same site.Of these patients,three underwent prostatectomy following biopsy.Among the 3 patients,1 patient was diagnosed with prostatic acinar adenocarcinoma(Gleason score was 7),accounting for 33.33%.Two patients were diagnosed with benign prostatic hyperplasia.The results of telephone follow-up of these patients showed that 14 patients(93.33%)survived.One patient was lost to follow-up(6.67%).Conclusions:in AAH patients,hyperplasia of acinus and disorderly arrangement of ducts were observed in the lesion.The stroma between acinus and ducts was reduced,and there was interstitial hyperplasia and inflammatory cell infiltration outside the lesion.In clinic,the disease should be diagnosed according to the results of laboratory examination,microscope examination and immunohistochemical examination,so as to reduce the rate of missed diagnosis and misdiagnosis.
作者
黄蓉飞
樊元春
余咸静
张君莉
Huang Rongfei;Fan Yuanchun;Yu Xianjing;Zhang Junli(The first affiliated hospital of chengdu medical college,chengdu,sichuan 610500,China)
关键词
前列腺非典型腺瘤样增生病变
病理特征
实验室检查
显微镜检查
免疫组化检查
atypical adenomatoid hyperplasia of prostate
Pathological features
Laboratory inspection
Microscopic examination
Immunohistochemical examination
