前列腺间质肉瘤临床与病理学特点分析

Prostatic stromal sarcoma:an analysis of clinical and pathologic characteristics

目的探讨前列腺间质肉瘤(PSS)的临床病理特征。方法回顾性分析3例PSS患者临床资料,采用免疫组织化学标记,在显微镜下观察组织学形态及免疫组化表达。结果3例均行前列腺姑息性肿瘤切除术,光镜下前列腺间质肉瘤主要由排列成束状、编织状的长梭形细胞构成,细胞异型性明显。免疫组化肿瘤细胞波形蛋白(Vimentin)、CD34及PR呈阳性表达。随访1～5年,2例于术后2年内死于肿瘤广泛转移,另1例术后5年出现肝脏等处转移。结论PSS是临床少见的恶性肿瘤,预后差。CD34阳性是诊断该肿瘤的重要依据之一。根治性前列腺切除是最可靠的治疗方案,化疗、放疗及抗激素类药物有一定疗效。

Objective To study the clinical and pathological features of prostatic stromal sarcoma（PSS）.Methods Three cases of PSS with light microscopy and immunohistochemical staining data were retrospectively analyzed.Results PSS palliation resection was performed in 3 cases.PSS was composed of long spindle-shaped cells,which arranged in interlacing fascicles and with moderate to high degree of cytological atypia.Immunohistochemically,vimentin,CD34 and progesterone receptor（PR）were positive.The patients were followed-up for 5 years,of whom 2 cases died of metastasis within 2 yeas and 1 case was alive but with liver metastasis.Conclusion PSS is a rare malignant tumor with poor prognosis.Positive of CD34 is one of the most important evidences for pathological diagnosis of PSS.The main treatment is radical prostatectomy at initial diagnosis followed by chemotherapy and/or radiotherapy.