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经会阴途径穿刺确诊的前列腺癌大体病灶空间分布

肖雨 严维刚 麦智鹏 梁智勇 纪志刚

肖雨, 严维刚, 麦智鹏, 梁智勇, 纪志刚. 经会阴途径穿刺确诊的前列腺癌大体病灶空间分布[J]. 协和医学杂志, 2016, 7(1): 18-22. doi: 10.3969/j.issn.1674-9081.2016.01.004
引用本文: 肖雨, 严维刚, 麦智鹏, 梁智勇, 纪志刚. 经会阴途径穿刺确诊的前列腺癌大体病灶空间分布[J]. 协和医学杂志, 2016, 7(1): 18-22. doi: 10.3969/j.issn.1674-9081.2016.01.004
Yu XIAO, Wei-gang YAN, Zhi-peng MAI, Zhi-yong LIANG, Zhi-gang JI. Gross Lesion Spatial Distribution of Prostate Cancer Confirmed by Transperineal Prostate Biopsy[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(1): 18-22. doi: 10.3969/j.issn.1674-9081.2016.01.004
Citation: Yu XIAO, Wei-gang YAN, Zhi-peng MAI, Zhi-yong LIANG, Zhi-gang JI. Gross Lesion Spatial Distribution of Prostate Cancer Confirmed by Transperineal Prostate Biopsy[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(1): 18-22. doi: 10.3969/j.issn.1674-9081.2016.01.004

经会阴途径穿刺确诊的前列腺癌大体病灶空间分布

doi: 10.3969/j.issn.1674-9081.2016.01.004
详细信息
    通讯作者:

    严维刚 电话:010-69156031, E-mail:yanwg111@126.com

  • 中图分类号: R602

Gross Lesion Spatial Distribution of Prostate Cancer Confirmed by Transperineal Prostate Biopsy

More Information
  • 摘要:   目的  探讨经会阴途径穿刺确诊的前列腺癌大体病理的病灶空间分布特点。  方法  北京协和医院2013年11月至2015年3月经会阴前列腺穿刺阳性且阳性区数≤ 6区的前列腺癌根治术后标本61例, 根据大体病理分为前、后半区为主肿瘤并比较肿瘤阳性率和肿瘤特点。进一步以尖部、中部和基底部为分区, 比较各部分的肿瘤分布情况。  结果  61个主要肿瘤中, 前半区为主肿瘤有32个(52.5%), 后半区为主肿瘤有29个(47.5%), 两者比较差异无统计学意义(χ2=0.295, P=0.587)。对于切缘阳性率和Gleason评分, 前半区为主肿瘤与后半区为主肿瘤相比较差异均无统计学意义。中部、尖部和基底部的肿瘤阳性率分别为96.7%、80.3%和29.5%, 平均单位体积肿瘤负荷分别为105.17、130.62和69.81 μl/ml。其中, 尖部与基底部相比有更高的肿瘤阳性率(χ2=31.816, P < 0.001)和单位体积肿瘤负荷(P=0.028)。  结论  经会阴前列腺穿刺阳性的前列腺癌大体病理前、后半区的肿瘤阳性率一致, 肿瘤特点相同。前列腺尖部比基底部有更高的肿瘤阳性率和单位体积肿瘤负荷。
  • 图  1  前列腺病理切片的Gleason评分(GS)

    A.前列腺中部大切片;B.前列腺尖部或基底部小切片

    表  1  前列腺癌根治术后标本中以前、后半区为主肿瘤比较

    肿瘤位置 例数(%) 切缘阳性[例(%)] GS≤6(例) GS=3+4(例) GS=4+3(例) GS≥8(例)
    前半区为主 32(52.5) 7(21.8) 4 19 6 3
    后半区为主 29(47.5) 6(20.7) 6 14 5 4
    χ2 0.295 0.013 0.744 0.755 0.023 0.292
    P 0.587 0.910 0.388 0.385 0.878 0.589
    GS:Gleason评分
    下载: 导出CSV

    表  2  前列腺癌根治术后标本中部、尖部和基底部肿瘤阳性率和单位体积肿瘤负荷比较

    部位 阳性例数 阳性率(%) 单位体积肿瘤负荷(M,μl/ml)
    中部 59 96.7 105.17(0.02~721.92)
    尖部 49 80.3* 130.62(0.20~520.71)
    基底部 18 29.5*†† 69.81(0.92~213.65)
    与中部比较,*P<0.01;与尖部比较,P<0.05,††P<0.01
    下载: 导出CSV
  • [1] Chang DT, Challacombe B, Lawrentschuk N. Transperineal biopsy of the prostate—is this the future?[J]. Nat Rev Urol, 2013, 10: 690-702. doi:  10.1038/nrurol.2013.195
    [2] Mabjeesh NJ, Lidawi G, Chen J, et al. High detection rate of significant prostate tumours in anterior zones using transperineal ultrasound-guided template saturation biopsy[J]. BJU Int, 2012, 110: 993-997. doi:  10.1111/j.1464-410X.2012.10972.x
    [3] Gershman B, Zietman AL, Feldman AS, et al. Transperineal template-guided prostate biopsy for patients with persistently elevated PSA and multiple prior negative biopsies[J]. Urol Oncol, 2013, 31: 1093-1097. doi:  10.1016/j.urolonc.2012.01.001
    [4] Matthew Andrews J, Ashfield JE, Morse M, et al. Five-year follow-up of active surveillance for prostate cancer: A Canadian community-based urological experience.[J]. Can Urol Assoc J, 2014, 8: 768-774. doi:  10.5489/cuaj.2186
    [5] Barqawi AB, Stoimenova D, Krughoff K, et al. Targeted focal therapy for the management of organ confined prostate cancer[J]. J Urol, 2014, 192:749-753. doi:  10.1016/j.juro.2014.03.033
    [6] Koppie TM, Bianco FJ Jr, Kuroiwa K, et al. The clinical features of anterior prostate cancers[J]. BJU Int, 2006, 98: 1167-1171. doi:  10.1111/j.1464-410X.2006.06578.x
    [7] 那彦群, 叶章群, 孙颖浩, 等.中国泌尿外科诊断治疗指南[M].北京:人民卫生出版社, 2014: 65.
    [8] Lemaitre L, Puech P, Poncelet E, et al. Dynamic contrast-enhanced MRI of anterior prostate cancer: morphometric assessment and correlation with radical prostatectomy findings[J]. Eur Radiol, 2009, 19: 470-480. doi:  10.1007/s00330-008-1153-0
    [9] Davis JW, Kim J, Ward JF, et al. Radical prostatectomy findings in patients predicted to have low-volume/low-grade prostate cancer diagnosed by extended-core biopsies: an analy-sis of volume and zonal distribution of tumour foci[J]. BJU Int, 2010, 105: 1386-1391. http://www.ncbi.nlm.nih.gov/pubmed/19888979/
    [10] Richters A, Derks J, Husson O, et al. Effect of surgical margin status after radical prostatectomy on health-related quality of life and illness perception in patients with prostate cancer[J]. Urol Oncol, 2015, 33: 16.e9-15. doi:  10.1016/j.urolonc.2014.10.006
    [11] McNeal JE, Redwine EA, Freiha FS, et al. Zonal distribution of prostatic adenocarcinoma. Correlation with histologic pattern and direction of spread[J]. Am J Surg Pathol, 1988, 12: 897-906. doi:  10.1097/00000478-198812000-00001
    [12] Chun FK, Epstein JI, Ficarra V, et al. Optimizing performance and interpretation of prostate biopsy a critical analysis of the literature[J]. Eur Urol, 2010, 58: 851-864. doi:  10.1016/j.eururo.2010.08.041
    [13] Rabbani F, Stroumbakis N, Kava BR, et al. Incidence and clinical significance of false-negative sextant prostate biopsies[J]. J Urol, 1998, 159: 1247-1250. doi:  10.1016/S0022-5347(01)63574-2
    [14] Epstein JI, Walsh PC, Sauvageot J, et al. Use of repeat sextant and transition zone biopsies for assessing extent of prostate cancer[J]. J Urol, 1997, 158: 1886-1890. doi:  10.1016/S0022-5347(01)64159-4
    [15] Bott SR, Young MP, Kellett MJ, et al. Anterior prostate cancer: is it more difficult to diagnose?[J].BJU Int, 2002, 89: 886-889. doi:  10.1046/j.1464-410X.2002.02796.x
    [16] Bouyé S, Potiron E, Puech P, et al. Transition zone and anterior stromal prostate cancers: zone of origin and intraprostatic patterns of spread at histopathology[J]. Prostate, 2009, 69: 105-113. doi:  10.1002/pros.20859
    [17] Breslow N, Chan CW, Dhom G, et al. Latent carcinoma of prostate at autopsy in seven areas. The International Agency for Research on Cancer, Lyons, France[J]. Int J Cancer, 1977, 20: 680-688. doi:  10.1002/ijc.2910200506
    [18] Kabalin JN, McNeal JE, Price HM, et al. Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: incidence, histology and morphometric observations[J]. J Urol, 1989, 141: 1091-1094. doi:  10.1016/S0022-5347(17)41178-5
    [19] Takashima R, Egawa S, Kuwao S, et al. Anterior distribution of Stage T1c nonpalpable tumors in radical prostatectomy specimens[J]. Urology, 2002, 59: 692-697. doi:  10.1016/S0090-4295(02)01525-X
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出版历程
  • 收稿日期:  2015-07-08
  • 刊出日期:  2016-01-30

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