经直肠超声引导下前列腺穿刺活检120例临床病理特征与免疫组化分析

Clinicopathological features and immunohistochemical analysis of 120 transrectal ultrasound guided prostate biopsies

目的探讨经直肠超声引导下前列腺穿刺活检120例临床病理特征及免疫组化分析结果,提高对前列腺癌的临床和病理诊断准确率。方法选取2018年7月至2019年7月永康市第一人民医院行直肠超声引导下前列腺穿刺活检的前列腺疾病患者120例的临床资料,对患者穿刺活检样本进行临床病理特征和免疫组化分析。结果120例患者中,经病理确诊检测前列腺癌(PCA)患者45例,占37.5%;前列腺上皮瘤变(PIN)Ⅰ级3例,占2.5%;良性前列腺增生症55例,占45.8%;不典型腺瘤样增生5例,占4.2%;慢性前列腺炎患者12例,占10.0%。病理结果显示,前列腺癌腺体结构紊乱,复杂多样,间质浸润,部分侵犯神经等病理形态改变。通过Gleason评分法进行分级,45例前列腺癌患者中,6例高分化腺癌(<5分),25例中分化癌(6~7分),14例低分化癌(≥8分)。免疫组化分析显示,前列腺癌患者p63和CK34βE12表达为阴性,P504S和PSA表达为阳性。结论经直肠超声引导下前列腺穿刺对前列腺癌诊断具有安全、准确、操作简便,是有效的诊断方法。可通过对临床病理特征与免疫组化分析进行综合判断,有助于前列腺疾病的鉴别诊断,能提高诊断的准确率。

Objective To investigate the clinical features and immunohistochemical analysis of 120 transrectal ultrasound-guided prostate biopsies,thus to improve the clinical and pathological diagnosis accuracy of prostate cancer.Methods From July 2018 to July 2019,the clinical data of 120 patients with prostate disease underwent transrectal ultrasound guided prostate biopsy in the First People's Hospital of Yongkang were selected.The clinicopathological features and immunohistochemical analysis were performed in the biopsy samples.Results Of the 120 patients,45 patients with prostate cancer(PCA)were diagnosed by pathology,accounting for 37.5%;3 patients with prostatic epithelial neoplasia(PIN)grade I,accounting for 2.5%;55 patients with benign prostatic hyperplasia,accounting for 45.8%;5 cases of atypical adenomatoid hyperplasia,accounting for 4.2%;12 cases of chronic prostatitis,accounting for 10.0%.Pathological results showed that the glandular structure of the prostate cancer was disordered,complicated and diverse,interstitial infiltration,and partial invasion of the pathological changes of the nerve.According to the Gleason scoring method,among 45 patients with prostate cancer,6 patients were highly differentiated adenocarcinoma(<5 points),25 patients were moderately differentiated(6-7 points),and 14 patients were poorly differentiated(≥8 points).Immunohistochemical analysis showed that p63 and CK34βE12 expression was negative in prostate cancer patients,and P504S and PSA expression was positive.Conclusion Transrectal ultrasound guided prostate puncture has great significance for the diagnosis of prostate cancer.It is safe,accurate and easy to operate.It is an effective diagnostic method.Comprehensive judgment of clinical pathological features and immunohistochemical analysis can help differential diagnosis of prostate diseases and improve the accuracy of diagnosis.