中国癌症杂志
中國癌癥雜誌
중국암증잡지
CHINA ONCOLOGY
2014年
11期
824-829
,共6页
常坤%杨晓群%王朝夫%甘华磊%郑爱华%杨珺%戴波%瞿元元%张海梁%施国海%朱耀%叶定伟
常坤%楊曉群%王朝伕%甘華磊%鄭愛華%楊珺%戴波%瞿元元%張海樑%施國海%硃耀%葉定偉
상곤%양효군%왕조부%감화뢰%정애화%양군%대파%구원원%장해량%시국해%주요%협정위
前列腺癌%病理大切片技术%根治性前列腺切除术
前列腺癌%病理大切片技術%根治性前列腺切除術
전렬선암%병리대절편기술%근치성전렬선절제술
Prostate cancer%Whole mount technique%Radical prostatectomy
背景与目的：在根治性前列腺切除术(radical prostatectomy，RP)组织标本中，应用病理大切片技术可以全面观察组织，其在病理诊断、形态学研究方面拥有独特的优势。但是由于制作技术、设备限制、工作量较大等原因，目前在临床上尚未常规开展。本研究通过比较RP后行常规切片及病理大切片患者的临床及病理变量，评价RP后病理大切片技术在前列腺癌诊断中的意义。方法：选择2012年12月—2014年2月在复旦大学附属肿瘤医院行RP后做病理大切片的229例前列腺癌患者作为研究组，同时选取2010年1月—2012年6月行RP后做常规病理切片的393例前列腺癌患者作为对照组，对比分析包括两组患者年龄，术前PSA值，术前是否接受新辅助内分泌治疗，前列腺癌确诊方式，确诊时Gleason评分、临床分期，RP后Gleason评分、病理分期、手术切缘、前列腺包膜外侵犯、精囊侵犯、术后盆腔淋巴结转移等变量。结果：两组患者术前临床及病理变量：RP后病理Gleason评分、病理分期、前列腺包膜外侵犯情况、术后盆腔淋巴结转移差异均无统计学意义(P>0.05)，但是研究组患者手术切缘及精囊侵犯的阳性率明显高于对照组，差异有统计学意义(26.2% vs 17.6%，P=0.010；23.1%vs 17.0%，P=0.025)。结论：应用病理大切片技术可明显提高前列腺标本切缘阳性及精囊侵犯的阳性检出率，因此病理大切片技术值得在前列腺癌病理诊断中推广。
揹景與目的：在根治性前列腺切除術(radical prostatectomy，RP)組織標本中，應用病理大切片技術可以全麵觀察組織，其在病理診斷、形態學研究方麵擁有獨特的優勢。但是由于製作技術、設備限製、工作量較大等原因，目前在臨床上尚未常規開展。本研究通過比較RP後行常規切片及病理大切片患者的臨床及病理變量，評價RP後病理大切片技術在前列腺癌診斷中的意義。方法：選擇2012年12月—2014年2月在複旦大學附屬腫瘤醫院行RP後做病理大切片的229例前列腺癌患者作為研究組，同時選取2010年1月—2012年6月行RP後做常規病理切片的393例前列腺癌患者作為對照組，對比分析包括兩組患者年齡，術前PSA值，術前是否接受新輔助內分泌治療，前列腺癌確診方式，確診時Gleason評分、臨床分期，RP後Gleason評分、病理分期、手術切緣、前列腺包膜外侵犯、精囊侵犯、術後盆腔淋巴結轉移等變量。結果：兩組患者術前臨床及病理變量：RP後病理Gleason評分、病理分期、前列腺包膜外侵犯情況、術後盆腔淋巴結轉移差異均無統計學意義(P>0.05)，但是研究組患者手術切緣及精囊侵犯的暘性率明顯高于對照組，差異有統計學意義(26.2% vs 17.6%，P=0.010；23.1%vs 17.0%，P=0.025)。結論：應用病理大切片技術可明顯提高前列腺標本切緣暘性及精囊侵犯的暘性檢齣率，因此病理大切片技術值得在前列腺癌病理診斷中推廣。
배경여목적：재근치성전렬선절제술(radical prostatectomy，RP)조직표본중，응용병리대절편기술가이전면관찰조직，기재병리진단、형태학연구방면옹유독특적우세。단시유우제작기술、설비한제、공작량교대등원인，목전재림상상상미상규개전。본연구통과비교RP후행상규절편급병리대절편환자적림상급병리변량，평개RP후병리대절편기술재전렬선암진단중적의의。방법：선택2012년12월—2014년2월재복단대학부속종류의원행RP후주병리대절편적229례전렬선암환자작위연구조，동시선취2010년1월—2012년6월행RP후주상규병리절편적393례전렬선암환자작위대조조，대비분석포괄량조환자년령，술전PSA치，술전시부접수신보조내분비치료，전렬선암학진방식，학진시Gleason평분、림상분기，RP후Gleason평분、병리분기、수술절연、전렬선포막외침범、정낭침범、술후분강림파결전이등변량。결과：량조환자술전림상급병리변량：RP후병리Gleason평분、병리분기、전렬선포막외침범정황、술후분강림파결전이차이균무통계학의의(P>0.05)，단시연구조환자수술절연급정낭침범적양성솔명현고우대조조，차이유통계학의의(26.2% vs 17.6%，P=0.010；23.1%vs 17.0%，P=0.025)。결론：응용병리대절편기술가명현제고전렬선표본절연양성급정낭침범적양성검출솔，인차병리대절편기술치득재전렬선암병리진단중추엄。
Background and purpose:To perform whole mount technique in the diagnosis of the prostate cancer could provide orientation to the specimen. Whole mount technique has great value in pathologic diagnosis and morphological research. However, limited by the specimen-making technique, shortage of equipment and heavy workload, this technique has not been generally accepted in China. The aim of this study was to evaluate the signiifcance of whole mount technique in the diagnosis of the prostate cancer by comparing the clinical and pathological variables between whole mount patients and conventional ones after radical prostatectomy (RP).Methods:A total number of 229 patients’ whole mount RP specimens were recruited in the study from Dec. 2012 to Feb. 2014. The control group included 393 patients’ specimens which underwent conventional sampling from Jan. 2010 to Jun. 2012. We compared the clinical and pathological variables between the groups, including age, preoperative PSA level, methods of diagnosis, preliminary diagnostic Gleason score, clinical T stage, postoperative Gleason score, pathological T stage, positive surgical margin, extraprostatic extension, seminal vesicle invasion and pelvic lymph node metastasis.Results:Two groups shared similar preoperative parameters. Also there was no signiifcant difference between the whole mount and the conventional sampling groups in postoperative Gleason score, pathological T stage, extraprostatic extension and pelvic lymph node metastasis. However, positive surgical margin and seminal vesicle invasion rates were much higher in the whole mount group than the control one and both of the differences reached statistical signiifcance (26.2%vs 17.6%, 23.1%vs 17.0%;P=0.010, 0.025)Conclusion:After compared the clinical and pathological variables, we could conclude that whole mount technique has prevalence in the diagnosis of the positive surgical margin and seminal vesicle invasion compared with the conventional sampling technique. Thus, whole mount technique should be strongly recommended in the diagnosis of prostate cancer.
