Samaratunga Hemamali, Gardiner Robert A, Yaxley John, Brown Ian
Department of Anatomical Pathology, Sullivan Nicolaides Pathology, Royal Brisbane Hospital, University of Queensland, Brisbane, Queensland, Australia.
Anal Quant Cytol Histol. 2006 Apr;28(2):104-10.
In recent times, PSA screening and a substantial increase in prostate needle biopsies have not only resulted in detection of minute foci of cancer but have also very likely resulted in increased detection of atypical glandular proliferations. Not uncommonly, there are only a limited number of atypical glands in these biopsies, and these require careful evaluation to enable an accurate diagnosis. We describe diagnostic implications, use of immunohistochemistry, and clinical significance of these lesions. Foci of atypical glands, also labeled atypical small acinar proliferation of uncertain significance, have features suspicious for but not diagnostic of cancer. Atypical foci include a broad group of lesions of differing clinical significance. These include benign, small acinar proliferations mimicking prostate cancer and atypical glandular proliferations suspicious for carcinoma. Definite diagnosis requires accurate histopathologic assessment and judicious use of immunohistochemistry. Patients with atypical glands on prostate needle biopsy have a high risk for harboring cancer and therefore have an increased risk for having cancer detected in subsequent biopsies.
近年来，前列腺特异性抗原（PSA）筛查以及前列腺穿刺活检数量的大幅增加，不仅导致了微小癌灶的检出，还很可能使非典型腺性增生的检出率上升。在这些活检中，非典型腺体数量通常有限，需要仔细评估才能做出准确诊断。我们描述了这些病变的诊断意义、免疫组化的应用及临床意义。非典型腺体灶，也被标记为意义不明确的非典型小腺泡增生，具有可疑但不能确诊癌症的特征。非典型灶包括一组临床意义各异的病变。这些病变包括良性的、酷似前列腺癌的小腺泡增生以及可疑为癌的非典型腺性增生。明确诊断需要准确的组织病理学评估和明智地使用免疫组化。前列腺穿刺活检发现有非典型腺体的患者患癌风险很高，因此在后续活检中检测到癌症的风险也会增加。
