单纯前列腺上皮内瘤临床和病理特征分析——附23例报告

Analysis on the clinical and pathological characteristics of simple prostatic intraepithelial neoplasia.

目的：探讨单纯前列腺上皮内瘤（prostatic intraep ithelial neop lasia,PIN）的临床和病理特征。方法：对23例低度（PIN 1级）PIN（低度组）和8例高度（PIN 2～3级）PIN（高度组）的临床资料进行数理分析,并以同期确诊为前列腺癌、BPH患者作为对照,分析上述各组患者临床和病理特征的差异。结果：高度组的血清总前列腺特异性抗原水平与低度组及BPH组比较差异均有统计学意义（均为P〈0.05）、前列腺特异性抗原密度与低度组比较差异有统计学意义（P〈0.05）。前列腺癌组的总前列腺特异性抗原、游离前列腺特异性抗原水平,前列腺体积及前列腺特异性抗原密度与其他3组比较差异均有统计学意义（P〈0.05～0.01）。免疫组织化学结果示低度PIN的特征类似于BPH而与前列腺癌有所不同,而少数（1/16）高度PIN患者的肿瘤标志物p504 s呈阳性。结论：低度PIN的临床和病理特征与BPH相似,而高度PIN的临床和病理方面具有一定的前列腺恶性肿瘤特征,需要积极进行临床追踪观察。

Objective： To study the clinical and pathological characteristics of simple prostatic intraepithelial neoplasia （PIN） . Methods： Clinical data of 23 patients with low grade prostatic intraepithelial neoplasia （ LGPIN group） and 8 patients with high grade prostatic intraepithelial neoplasia （ HGPIN group） were collected and analyzed retrospectively, and compared with the data of the patients with final diagnosis of prostatic carcinoma （PC group） or benign prostatic hyperplasia （BPH group） . Results： The level of serum total prostate specific antigen （tPSA） was statistically different between HGPIN group and LGPIN group or BPH group （P 〈 0. 05） . The prostate specific antigen density （PSAD） was statistically different between HGPIN group and LGPIN group （P 〈 0.05 ） . The data including the level of tPSA and free prostate specific antigen, the volume of prostate and PSAD were statistically different between PC group and the other groups （ P 〈 0. 05～ 0. 01 ） . According to the immunohistochemical report, the characteristics of LGPIN group were similar to that of BPH but PC group. The tumor marker p504s was found to be positive in one patient with HGPIN. Conclusion： The clinical and pathological characteristics of LGPIN are similar to that of BPH. HGPIN has some clinical and pathological characteristics of PC. The patients with HGPIN need follow-up actively.