转移性前列腺癌的临床病理特征分析

Clinicopathological features of metastatic prostate cancer

目的探讨转移性前列腺癌转移病灶的临床及组织病理学特征。方法收集上海市第一人民医院2013年1月-2019年3月诊断为前列腺腺癌转移的病例24例,采用回顾性分析的方法,对其转移灶的部位和数量进行分析,并观察转移灶组织病理学改变及免疫组织化学相关指标的表达。结果 24例病人中,转移部位有骨和远处淋巴结、肠道、输尿管、肺、肝脏、腹膜后,大部分骨转移患者为多灶性转移。转移灶肿瘤细胞多大小一致,核仁明显,部分可见核深染细胞,胞浆淡染或红染。免疫组织化学染色CK7-(13/14),CK20-(14/14),PSA+( 14/14)。结论骨转移是前列腺癌的常见部位,但仍有部分患者出现少见部位的转移,并以首发症状就诊,认识前列腺癌的可能转移部位有助于临床精准诊疗。对于CK7-.CK20-的上皮性肿瘤的老年男性患者,应考虑到前列腺癌的可能,加做PSA明确诊断。

Objective To investigate the clinical and histopathological features of metastatic prostate cancer. Methods Clinical data of 24 metastatic prostate adenocarcinoma diagnosed by Shanghai First People's Hospital from January 2013 to March 2019 were collected. The location and number of metastatic lesion were analyzed retrospectively. The histopathological features and immunohistochemical expression of metastatic lesion were observed. Results Metastatic sites of 24 patients distribute at bone, distant lymph nodes, intestinal tract, ureter, lung, liver and retroperitoneum. Most patients with bone metastasis were multifocal metastases. Tumor cells in metastatic lesions were similar in size, with prominent nucleoli. Some of them were dark-stained cells with light or red cytoplasm. Immunohistochemical staining showed CK7-(13/14), CK20-(14/14) and PSA +(14/14). Conclusion Bone metastasis is a common site of prostate cancer, but some patients have atypical metastasis sites as the first symptoms. Understanding the possible metastasis site of prostate cancer is helpful for accurate clinical diagnosis and treatment. For elderly male patients with CK7-, CK20-epithelial tumors, the possibility of prostate cancer should be considered, and PSA should be added to make a definite diagnosis.