穿刺活检前列腺癌72例病理形态学观察及Gleason分级

Pathologic diagnosis and Gleason grading of prostatic carcinoma by transrectal ultrasound-guided prostate needle biopsy

目的观察经直肠超声引导的前列腺癌穿刺活检组织的病理形态学改变,进行系统的Gleason分级。方法收集经直肠超声引导的前列腺穿刺活检诊断的前列腺癌72例,复习HE组织切片,并依据2005年国际泌尿病理学协会(ISUP)修订的前列腺癌Gleason分级系统进行分级。结果 72例前列腺癌中53例的主要及次要成分为3级结构(73.6%),59例主要及次要成分为4级结构(81.9%),12例主要及次要成分为5级结构(16.7%)。结论本组前列腺癌Gleason 4级结构与3级结构常常混合存在,而且4级结构相比3级结构更为常见。修订后的Gleason分级系统有助于对前列腺癌进行规范分级,以利于进一步研究,准确反映肿瘤的预后差异。

Abstract： Objective To study the morphological diagnostic criteria and Gleason grading of prostatic carcinoma in transrectal ultrasound guided prostate needle biopsy. Methods 72 cases of prostatic needle biopsy guided by transrectal ultrasound were reviewed. Routine pathological examination was used in the study. Data with respect to Gleason grading were studied according to the refinements of the ISUP 2005 consensus conference on Gleason grading of needle biopsies. Results The results showed that Gleason pattern 3 was seen in 73.61% ; pattern 4 in 81.94% ; pattern 5 in 16. 67% among 72 cases of prostatic carcinoma. Conclusions Most of the tumors show at least two different patterns, and the pattern 4 is more common than pattern 3. The use of modified Gleason scoring leads to improves the prognostic value of the patients with prostate cancer and can be more accurately assessed in transrectal ultrasound guided prostate needle biopsy. Continued effort is required to refine biopsy strategies to Gleason grading of prostatic specimens.