CAJ | 학술논문

目的：应用前列腺癌根治术标本的全器官取材方法观察前列腺癌的临床病理学特征。方法系统性全器官取材前列腺癌根治标本108例,并复习相关临床病理资料。结果患者年龄55~80岁(平均68．1岁),术前血清PSA平均值18．3μg/ml。病理分期：pT2期59例(54．6%,59/108),其中14例为pT2a期(23．7%,14/59),5例为pT2b期(8．5%,5/59),40例为pT2c期(67．8%,40/59)；pT3期49例(45．4%,49/108)；pT3a期29例(59．2%,29/49),其中pT3b期20例(40．8%,20/49)。84例同时送检盆腔淋巴结,3例可见淋巴结转移(转移率3．6%)。 Gleason评分：9例≤6分(8．3%),66例为7分(61．1%),33例≥8分(占30．6%)。29例存在Gleason 5生长方式。切缘状况：28例(25．9%)呈切缘阳性,21例为pT3期(75%),15例(53．6%)存在Gleason 5生长方式。术前活检与术后病理分期比较：pT2期肿瘤术前PSA平均值14．00μg/ml,肿瘤累及针数≤2针者占68．5%,>5针者占4．3%；pT3期肿瘤术前PSA平均值23．82μg/ml,肿瘤累及针数≤2针者占19．6%,>5针者占28．3%。 pT2期与pT3期肿瘤活检累及针数差异有统计学意义(P<0．01)。术前活检指标在Gleason 6分者81．3%根治标本上升为7分或以上。结论要获得准确的病理分期、分级及切缘状况评估需全器官系统化取材前列腺癌根治标本。 PSA水平、Gleason评分、肿瘤累及针数是前列腺癌术前临床分期和危险度评估的良好指标。
목적：응용전렬선암근치술표본적전기관취재방법관찰전렬선암적림상병이학특정。방법계통성전기관취재전렬선암근치표본108례,병복습상관림상병리자료。결과환자년령55~80세(평균68．1세),술전혈청PSA평균치18．3μg/ml。병리분기：pT2기59례(54．6%,59/108),기중14례위pT2a기(23．7%,14/59),5례위pT2b기(8．5%,5/59),40례위pT2c기(67．8%,40/59)；pT3기49례(45．4%,49/108)；pT3a기29례(59．2%,29/49),기중pT3b기20례(40．8%,20/49)。84례동시송검분강림파결,3례가견림파결전이(전이솔3．6%)。 Gleason평분：9례≤6분(8．3%),66례위7분(61．1%),33례≥8분(점30．6%)。29례존재Gleason 5생장방식。절연상황：28례(25．9%)정절연양성,21례위pT3기(75%),15례(53．6%)존재Gleason 5생장방식。술전활검여술후병리분기비교：pT2기종류술전PSA평균치14．00μg/ml,종류루급침수≤2침자점68．5%,>5침자점4．3%；pT3기종류술전PSA평균치23．82μg/ml,종류루급침수≤2침자점19．6%,>5침자점28．3%。 pT2기여pT3기종류활검루급침수차이유통계학의의(P<0．01)。술전활검지표재Gleason 6분자81．3%근치표본상승위7분혹이상。결론요획득준학적병리분기、분급급절연상황평고수전기관계통화취재전렬선암근치표본。 PSA수평、Gleason평분、종류루급침수시전렬선암술전림상분기화위험도평고적량호지표。
Purpose To study clinicopathologic feature of prostate cancer by complete embedding of radical prostatectomy specimen. Methods 108 cases of radical prostatectomy by systematic whole organ embedding were reviewed. Results The patient age ranged from 55 to 80 years ( mean 68. 1 years) . The preoperative average PSA value was 18. 3μg/ml. 59 cases ( accounting for 54. 6% of all prostatectomy cases) were in pT2 stage, while 23. 7% (14/59) in pT2a stage, 8. 5% (5/59) in pT2b, and 67. 8% (40/59) in pT2c. 49 cases (45. 4%)in pT3 stage, while 59. 2% (29/49) in pT3a, 40. 8% (20/49) in pT3b. 3. 6%(3/84)cases presented pelvic lymph node metastasis. 8. 3% (9/108) cases were graded as Gleason Score 6 or less, 61. 1% Gleason Score 7, 30. 6%(33/108)Gleason Score 8 or more. Gleason Pattern 5 component was found in 26. 9% (29/108) cases. Positive margin was observed in 25. 9% (28/108) cases, with 75% (21/28) in pT3 stage and 53. 6% (15/28) having Gleason Pattern 5. Patient in pT2 stage pres-ented mean PSA value of 14. 00 μg/ml, involved in no more than 2 biopsy cores in 68. 5% cases, and more than 5 cores in 4. 3%, while in pT3 stage, presented mean PSA value of 23. 82μg/ml, involved in no more than 2 cores in 19. 6%, and more than 5 cores in 28. 3%. The difference of involved core number was significant in pT2 and pT3 tumors ( P<0. 01 ) . 81. 3% cases graded Gleason Score 6 in biopsy was assigned to Gleason Score 7 or more in prostatectomy. Conclusions Completely sampling radical prostatectomy specimen should be recommended for accurate staging and margin status. Preoperative PSA value, Gleason Score of biopsy, involved core number by cancer is a still helpful parameter for clinical staging and risk estimate.