153例经直肠前列腺穿刺活检病例临床病理及免疫组化分析

The Analysis of Clinical Pathology and Immunohistochemical Staining in the Prostate Biopsies:a Report of 153 Cases

目的:对经直肠前列腺穿刺活检病例的临床资料、病理形态学及免疫组化进行分析,以提高对前列腺癌的临床及病理诊断准确率。方法:回顾性分析我院2006年1月～2011年6月间153例行前列腺穿刺活检病人的临床及病理资料,研究其血清PSA、病理形态学特点,并将其中确诊为前列腺癌患者50例与良性前列腺病变患者103例进行对比分析。结果:前列腺癌50例,血清PSA平均值为(84.54±32.99)ng/ml,免疫组化显示,PSA阳性率为96%.P504s阳性率为94%,CK34βE12和P63阳性率分别为33.3%和20.4%;良性前列腺病变103例,其中良性前列腺增生96例,血清PSA平均值为(11.29±1.086)ng/ml,免疫组化显示,PSA阳性率为100%,CK34βE12和P63阳性率分别为99%和98.9%,P504s局灶性弱阳性率为1%;前列腺上皮内瘤变(PIN)7例,血清平均PSA为(20.314±10.10)ng/ml,免疫组织化学显示,PSA阳性率为100%,CK34βE12和P63阳性率分别为85.7%和85.7%,P504s局灶性弱阳性率为42.9%。结论:结合临床资料、病理形态学改变及免疫组化进行综合分析,能够提高前列腺癌诊断和鉴别诊断的准确率。

Objective To improve the accuracy of the clinical and pathological diagnosis in prostate carcinoma by analysing clinical date,pathomorphology and immunohistochemical staining of biopsy specimen acquired by prostate paracentesis through rectum.Methods retrospectively analysed the clinical and pathological date of 153patients in our hospital from January 2006 to June 2011,and investigated the information about PSA and pathology.Finally,50 patients with prostate carcinoma and 103cases of benign prostate lesions were analyzed contrastively in these patients.Result In the 50 cases with prostate carcinoma,the serum PSA mean of patients was（84.54±132.99）ng/ml,the immunohistochemistry showed PSA positive rate was 96%.P504s positive rate was 94%,CK34βE12and P63positive rate was 33.3% and 20.4%.103 cases of benign prostate disease,96 cases of these patients were diagnosed benign prostatic hyperplasia,the serum PSA mean of them was（84.54±32.99）ng/ml.The immunohistochemistry showed that： PSA positive rate was 100%,CK34βE12and P63positive rate was 99% and 98.9%,P504sfocal weak positive rate of 1%.Other seven cases were diagnosed prostatic intraepithelial neoplasia（PIN）,the serum PSA mean of patients was（20.314±10.10）ng/ml,the immunohistochemistry showed PSA positive rate was 100%,CK34βE12and P63positive rate was 85.7% and 85.7%,P504spositive rate was 42.9%.Conclusion Combined with clinical date,pathomorphology change and immunohistochemical index,the accuracy rate of diagnosis and differential diagnosis in prostate carcinoma was improved remarkably.