Kernek K M, Koch M O, Daggy J K, Juliar B E, Cheng L
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, University Hospital 3465, 550 North University Blvd, Indianapolis, IN 46202, USA.
J Clin Pathol. 2005 Jul;58(7):725-8. doi: 10.1136/jcp.2004.024182.
Serum prostate specific antigen (PSA) increases after radical prostatectomy are thought to indicate recurrent disease, although some suggest they result from benign prostatic epithelial tissue left at surgical margins.
To investigate whether presence, location, and extent of benign prostatic tissue at radical prostatectomy surgical margins influence patient outcome.
One hundred and ninety nine patients with prostate cancer and negative surgical margins were studied. The prostectomy specimens were totally embedded using the whole mount technique. The apex and bladder neck, dissected as a cone from the specimen, were serially sectioned. The total length of benign prostatic tissue at the margins, measured for each location using an ocular micrometer, was obtained by summing the length of all positive sites. The presence, anatomical location, and extent of benign prostatic tissue at the margin were correlated with clinicopathological characteristics and postoperative PSA increases.
Fifty five cases had benign prostatic glandular tissue at the surgical margin. The mean length was 2.19 mm (0.1-14.7). The most frequent location of benign prostatic tissue was the apex (40 patients). Presence, anatomical location, and length of benign prostatic tissue at the margin were not significantly associated with age, preoperative PSA, prostate weight, pathological stage, tumour volume, largest tumour dimension, Gleason score, extraprostatic extension, seminal vesical invasion, tumour multifocality, perineural invasion, or PSA recurrence.
Benign prostatic tissue was frequently found in margins of apex and bladder base, but uncommon in the anterior or posterior prostate. The presence of benign prostatic tissue at surgical margins had no prognostic relevance.
根治性前列腺切除术后血清前列腺特异性抗原（PSA）升高被认为提示疾病复发，尽管有人认为这是手术切缘残留的良性前列腺上皮组织所致。
研究根治性前列腺切除术手术切缘处良性前列腺组织的存在、位置和范围是否会影响患者预后。
对199例前列腺癌且手术切缘阴性的患者进行研究。采用全组织包埋技术将前列腺切除标本完全包埋。从标本上切下作为锥体的尖部和膀胱颈部，并进行连续切片。使用目镜测微计测量每个位置切缘处良性前列腺组织的总长度，通过将所有阳性部位的长度相加得出。切缘处良性前列腺组织的存在、解剖位置和范围与临床病理特征及术后PSA升高情况相关。
55例患者手术切缘存在良性前列腺腺组织。平均长度为2.19毫米（0.1 - 14.7）。良性前列腺组织最常见的位置是尖部（40例患者）。切缘处良性前列腺组织的存在、解剖位置和长度与年龄、术前PSA、前列腺重量、病理分期、肿瘤体积、最大肿瘤直径、Gleason评分、前列腺外侵犯、精囊侵犯、肿瘤多灶性、神经周围侵犯或PSA复发均无显著相关性。
在尖部和膀胱底部切缘经常发现良性前列腺组织，但在前部或后部前列腺中不常见。手术切缘处良性前列腺组织的存在与预后无关。
