前列腺导管腺癌35例基底细胞变化形态学.docVIP

前列腺导管腺癌35例基底细胞变化形态学 　 作者：赵红艳，叶明福，王亚丽，汤金梁，陈锐 【摘要】 目的: 探讨前列腺导管腺癌(PDA)基底细胞的病变特点，为前列腺癌的病理诊断提供依据. 方法: 收集PDA标本35例，应用光镜、免疫组化EliVisionTM Plus二步法，选择34βE12, P63, P504S, PSA, PSAP抗体检测，观察PDA中基底细胞的缺失情况. 结果: HE切片中35例PDA的基底细胞变化难以确定，但免疫组化显示13例PDA多数癌巢周围有较完整的基底细胞，3例PDA仅少数基底细胞残存，19例PDA基底细胞完全缺失；本组病例中27例PDA边缘少数小片状浸润癌和/或小腺泡癌成分中P504S阳性、34βE12、P63均阴性. 结论: 本研究发现35例PDA中的基底细胞尽管有明显缺失，但残存比率较高，提示在日益增多的前列腺穿刺标本中，基底细胞缺失并非是PDA诊断的最重要指标，若对基底细胞缺失期望值过高，则容易造成误诊或漏诊. 【关键词】 前列腺肿瘤；导管腺癌； 基底细胞；免疫组化 　　【Abstract】 AIM: To investigate the clinicopathological features of basal cells in prostatic duct adenocarcinoma which can help pathological diagonosis of prostatic cancer. METHODS: Thirtyfive cases of prostatic duct adenocarcinoma were studied by hematoxylin and eosin staining and immunohistochemical techniques of twostep ElivisionTM Plus method to detect the expression of 34βE12, P63, P504S, PSA and PSAP. And the abscence of basal cells in prostatic duct adenocarcinoma was analysed according to the immunohistochemical staining. RESULTS: Of the total 35 cases, nearly intact basal cells were observed by immunohistochemical staining in 13 cases;only small amounts of incomplete basal cells in 3 cases; and complete absence of base cells in 19 cases 27 cases with P504S positive, 34βE12 and P63 negative staining at the edge of small invasive carcinoma and/or small acinous carcinoma around the prostatic duct adenocarcinoma were also observed. CONCLUSION: Although obvious absence of basal cells is usually observed in prostate duct adenocarcinoma, some basal cells still remain in the tumor tissues, which shows that the absence of basal cells is not the most significant index on the pathological diagnosis of prostate duct adenocarcinoma, and too much dependence on the importance of basal cell absence in diagnosis of prostate duct adenocarcinoma will lead to misdiagnosis and missed diagnosis. 　　【Keywords】 prostatic neoplasms; duct adenocarcinoma; basal cell; immunohistochemistry 　　0 引言 　　前列腺导管腺癌（prostate duct adenocar