Che Mingxin, Sakr Wael, Grignon David
Department of Pathology, Harper University Hospital, Wayne State University, Karmanos Cancer Institute, 3990 John R, Detroit, MI 48201, USA.
Urol Oncol. 2003 Mar-Apr;21(2):153-61. doi: 10.1016/s1078-1439(03)00008-5.
In recent years, the pathological evaluation of prostate biopsy specimens has made great improvements in diagnostic accuracy and comprehensiveness. In this article, we review major pathological findings on prostate biopsy, their interpretation and reporting, as well as their clinical significance and utility. We discuss especially the clinically relevant histological features in either a positive or negative biopsy. We emphasize that both Gleason score and extent of cancer involvement in a needle core biopsy are important predictors of clinical outcome after either radical prostatectomy or radiation. Special issues regarding diagnosis and grading of minimal cancer on needle core biopsies are discussed. We also highlight the current standards on high-grade prostatic intraepithelial neoplasia and atypical small acinar proliferation on needle core biopsies. In summary, the pathology reports on needle biopsies are far beyond the simple presence or absence of cancer; they contain invaluable information to clinicians on patient management and counseling.
近年来，前列腺活检标本的病理评估在诊断准确性和全面性方面取得了巨大进展。在本文中，我们回顾了前列腺活检的主要病理发现、其解读与报告，以及它们的临床意义和用途。我们特别讨论了活检阳性或阴性时具有临床相关性的组织学特征。我们强调，在针芯活检中，Gleason评分和癌症累及范围都是根治性前列腺切除术或放疗后临床结果的重要预测指标。文中还讨论了针芯活检中微小癌诊断和分级的特殊问题。我们还强调了针芯活检中高级别前列腺上皮内瘤变和非典型小腺泡增生的当前标准。总之，针吸活检的病理报告远不止简单的有无癌症；它们为临床医生提供了关于患者管理和咨询的宝贵信息。
