Berney D M, Fisher G, Kattan M W, Oliver R T D, Møller H, Fearn P, Eastham J, Scardino P, Cuzick J, Reuter V E, Foster C S
Department of Histopathology, St Bartholomew's Hospital, London, UK.
Histopathology. 2007 Oct;51(4):452-7. doi: 10.1111/j.1365-2559.2007.02819.x.
To assess the possible reasons for error in the diagnosis of prostatic cancer with available follow-up data.
A cohort of 1791 cases of prostatic cancer diagnosed in the UK between 1990 and 1996 was examined. All cases were clinically localized at presentation, treated by non-curative methods and detailed follow-up was available. A panel of genitourinary pathologists reviewed the pathology of all cases. One hundred and thirty-three (7.5%) of cases were reassigned to a non-malignant diagnosis. Where possible, reasons for the initial diagnosis were given. These included severe atrophy, inflammatory induced atypia, sclerosing adenosis, atypical adenomatous hyperplasia and basal cell hyperplasia. Follow-up of these patients showed an extremely low death rate from prostatic cancer: lower than that for the Gleason combined score of five or less tumours diagnosed in this series.
Many morphological entities potentially mimic prostatic cancer and may be responsible for misdiagnosis in routine specimens. Continuing education in prostatic morphology and immunohistochemistry may have helped reduce this error rate.
利用现有随访数据评估前列腺癌诊断错误的可能原因。
对1990年至1996年间在英国诊断出的1791例前列腺癌病例进行了研究。所有病例在初诊时均为临床局限性病变，采用非根治性方法治疗，并可获得详细的随访资料。一组泌尿生殖病理学家对所有病例的病理进行了复查。133例（7.5%）病例被重新诊断为非恶性病变。在可能的情况下，给出了初始诊断的原因。这些原因包括严重萎缩、炎症性非典型增生、硬化性腺病、非典型腺瘤样增生和基底细胞增生。对这些患者的随访显示，前列腺癌死亡率极低：低于本系列中诊断出的Gleason总分5分及以下肿瘤的死亡率。
许多形态学实体可能酷似前列腺癌，可能是常规标本误诊的原因。前列腺形态学和免疫组织化学方面的继续教育可能有助于降低这一错误率。
