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

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

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

摘要

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。

Abstract:
Objective To demonstrate the gross lesion spatial distribution of prostate cancer confirmed by template-guided transperineal prostate biopsy (TTPB).
Methods This study enrolled 61 consecutive patients diagnosed as prostate cancer with no more than 6 positive regions on TTPB between November 2013 and March 2015 in Peking Union Medical College Hospital. With radical prostatectomy specimens from these patients, we compared the tumor frequencies and characteristics on anterior and posterior zones in gross pathology. The lesion spatial distributions were further compared among apex, middle, and base of prostate.
Results Of the 61 predominant tumors, the anterior (APCs) and posterior prostate cancers (PPCs) were 32 (52.5%) and 29 (47.5%), with no significant difference (χ²=0.295, P=0.587). There was no difference in positive surgical margin or Gleason score (GS) between APCs and PPCs. The tumor frequencies of apex, middle, and base of prostate were 96.7%, 80.3%, and 29.5%, respectively; the tumor loads per unit volume were 105.17, 130.62, and 69.81 μl/ml, respectively. Compared with the base, the apex had a higher tumor frequency (χ²=31.816, P < 0.001) and tumor load (P=0.028).
Conclusions The tumor frequencies and pathological characteristics observed in gross pathology of the anterior and posterior zones of whole-mounted radical prostatectomy specimens may be similar in TTPB-confirmed prostate cancer. Compared with the base of prostate, the apex may be associated with a higher tumor frequency and tumor load.

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