伴有肾小球样结构的前列腺癌

Prostatic adenocarcinoma with glomeruloid structure

目的:探讨肾小球样结构在前列腺癌病理切片中的形态学特征、发生率、与临床特征的联系以及对预后判断的意义。方法:收集华中科技大学同济医学院附属同济医院196例前列腺癌患者的临床资料、病理诊断、Glea-son评分以及TNM分期等,对病理报告伴有肾小球样结构的病例分析其组织学特征,结合文献分析肾小球样结构对前列腺癌诊断、预后的意义。结果:196例前列腺癌标本中3例出现肾小球样结构,其中2例伴有周围神经侵犯,1例伴有骨转移;Gleason评分分别为7分、8分和8分;随访5～15个月,1例已死亡,1例在接受内分泌治疗,1例行前列腺癌根治术后处于随访中。结论:肾小球样结构是一种少见的前列腺癌病理特征,其形态学特征鲜明,对前列腺恶性病变具有诊断价值并提示较差的预后。

Objective： To investigate the architectural features and frequency of glomeruloid features in pathological section of prostatic adenocarcinoma and evaluate the association between glomerulations and its clinical data.Methods： We studied 196 prostatic adenocarcinoma specimens obtained from needle biopsies or radical prostatectomy and their clinical data,and reviewed related literatures.Results： Three of the 196 cases showed glomeruloid features,the Gleason score of which was 7,8,and 8,respectively.Of the 3 cases 1 had osseous metastasis and 2 extraprostatic nervus extension.After 5 to 15 months＇ follow-up,1 case died and the other 2 still under treatment.Conclusion： Glomeruloid structures in the prostate represented an uncommon but distinctive growth pattern that was specific for malignancy.Glomeruloid structures were usually seen in high-grade adenocarcinoma,often with extraprostatic extension.