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[非典型增生、发育异常与前列腺癌的关系及其出现对临床医生的意义]

[Relations between atypical hyperplasia, dysplasia and prostatic cancer and the significance of its appearance for the clinician].

作者信息

Hoffmann L, Putzke H P, Günther I, Rodewald P, Erdmann T

机构信息

Urologische Klinik, Bereiches Medizin der Wilhelm-Pieck-Universität Rostock.

出版信息

Z Urol Nephrol. 1987 Oct;80(10):561-9.

PMID:2448971
Abstract

In 89 preparations of patients with a carcinoma of the prostate and 100 preparations of patients with a hyperplasia of the prostate (adenoma of the neck of the bladder) the appearance of primarily atypical hyperplasias was investigated. In these cases in the carcinoma group in the uniform as well as in the pluriform carcinomas a coincidence of carcinoma and atypical hyperplasia of 55% was found. The coincidence is particularly high in adenocarcinomas and in carcinomas with dominating adenoid part, respectively, i. e. in more mature glandular structures. Among the various histological types of the atypical hyperplasia the microglandular/papillary clear-cellular form is dominating with 82%. In the group of the benign hyperplasia of the prostate gland a coincidence of the atypical hyperplasia of 33% was found. Though this rate, in comparison to other investigators, seems to be relatively high, it is still significantly lower than in the carcinoma. From this follows that the atypical hyperplasia, particularly its severest forms and dysplastic deformations from other hyperplasias (postatrophic hyperplasia, basal cell hyperplasia, atrophy and metaplasia of the prostate) now as ever are suspected that these cases in question are precancerous lesions. For the clinically working urologist the task is derived in such histopathological diagnoses by clinical and bioptical follow-up controls to find an already existing, but still unrecognized, or developing carcinoma of the prostate gland. In no case the diagnosis may cause surplus therapeutic consequences.

摘要

对89例前列腺癌患者的标本和100例前列腺增生(膀胱颈部腺瘤)患者的标本进行了原发性非典型增生情况的研究。在这些病例中,在癌组的单形性癌和多形性癌中,发现癌与非典型增生的符合率为55%。在腺癌和以腺样部分为主的癌中,符合率尤其高,即在更成熟的腺结构中。在各种组织学类型的非典型增生中,微腺管/乳头状透明细胞型占主导,为82%。在前列腺良性增生组中,非典型增生的符合率为33%。虽然与其他研究者相比,这个比例似乎相对较高,但仍明显低于癌组。由此可见,非典型增生,尤其是其最严重的形式以及与其他增生(萎缩后增生、基底细胞增生、前列腺萎缩和化生)不同的发育异常变形,一直以来都被怀疑这些相关病例是癌前病变。对于临床工作的泌尿科医生来说,任务是通过临床和活检随访控制在这种组织病理学诊断中发现已经存在但仍未被识别或正在发展的前列腺癌。在任何情况下,诊断都不应导致过度的治疗后果。

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