前列腺癌患者去势治疗后癌组织病理改变及其相关因素的探讨

Histopathological changes of prostate cancer after castration therapy and correlative factors

目的 探讨前列腺癌患者经睾丸切除去势治疗后 ,癌组织的病理改变及其相关因素。方法 对 17例前列腺穿刺标本中明确诊断为前列腺癌 ,又行睾丸切除去势疗法后前列腺切除术的病例 ,通过光镜和图像分析系统观察去势治疗前后 ,前列腺癌组织病理形态学的改变 ,并分析了其形态改变的相关因素。结果 睾丸切除去势疗法后 ,前列腺癌组织的主要病理改变为 ,腺体萎缩 ,胞浆空泡化 ,细胞核固缩 ,间质相对增多。患者的年龄与去势治疗后前列腺癌组织的萎缩程度之间有显著相关性 (P <0 .0 5 )。去势治疗前 ,肿瘤的临床分期、分化程度以及血清前列腺特异性抗原水平均与睾丸切除去势治疗后 ,前列腺癌组织的萎缩程度无明显相关 (P >0 .0 5 )。结论 睾丸切除去势疗法更适合于高龄前列腺癌患者 。

Objective To study the histopathological changes of prostate cancer after castration thera py among Chinese and correlative factors. Methods Needl e biopsy specimens and prostatectomy specimens were obtained from 17 cases of pr ostate cancer and examined by light microscopy and image analysis system. Results Glandular atrophy, cytoplasmic vacuolization, nuclear pyknosis, and relative increase of stroma could be seen after orchectomy. There was a close correlatio n between atrophy of neoplastic tissue in prostate gland and patients' age ( P <0. 05). The atrophy of neoplastic tissue in prostate gland was not correlated with the serum PSA, tumor staging and grading before castration therapy ( P >0.05). Conclusion Castration is effective for treatment of prostate cancer, especially a mong the elderly patients. It is important for pathologists to recognize the his topathological changes in the prostectomy specimens made untypical by castration .