65 岁以下经尿道前列腺切除术标本中偶然发现的前列腺癌。
Incidental prostate cancer in transurethral resection of prostate specimens in men aged up to 65 years.
机构信息
School of Medicine, University of Queensland, St Lucia, QLD, Australia; Department of Surgery, University of Melbourne, VIC, Australia.
Department of Surgery, University of Melbourne, VIC, Australia; Ludwig Institute for Cancer Research, Austin Hospital, Heidelberg, VIC, Australia; Department of Urology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
出版信息
Prostate Int. 2016 Mar;4(1):11-4. doi: 10.1016/j.prnil.2015.10.016. Epub 2015 Nov 26.
BACKGROUND
The identification of prostate cancer (PC) is important in men aged ≤ 65 years. We examined complete transurethral resection of prostate (TURP) specimens to quantify the incidence and nature of PC in men aged ≤ 65 years.
METHODS
A prospective multi-institutional database included TURP specimens. The cohort was stratified into two groups according to age. For men aged ≤ 65 years, the entire specimen was submitted for histological analysis, while the TURP specimens from men aged > 65 years were sampled following standard guidelines.
RESULTS
A total of 923 men were included, with 224 in the younger group. PC was identified in 13.4% in men aged ≤ 65 years, compared with 28.7% the older group. The younger group had a lower proportion of Gleason score ≥ 7 (30% compared with 40%) and higher rates of pT1a (57% compared with 43%). In men aged ≤ 65 years with cancer, tumor was identified in one block in 15 of 30 cases (50%). Following diagnosis, 4/30 underwent radical prostatectomy, 5/30 underwent curative radiotherapy, 10/30 androgen deprivation, and 1/30 received palliative radiotherapy.
CONCLUSION
Incidental PC in men aged ≤ 65 years is not uncommon. Our results suggest that TURP specimens in men aged ≤ 65 years should be completely assessed. Underidentification of cancer may occur as a result of increasing use of laser prostatectomy and the consequent loss of tissue for pathological examination.
背景
在年龄≤65 岁的男性中，前列腺癌（PC）的识别非常重要。我们检查了完整的经尿道前列腺切除术（TURP）标本，以量化年龄≤65 岁男性中 PC 的发生率和性质。
方法
一个前瞻性多机构数据库包括 TURP 标本。该队列根据年龄分为两组。对于年龄≤65 岁的男性，整个标本均进行组织学分析，而年龄>65 岁的男性的 TURP 标本则按照标准指南进行采样。
结果
共纳入 923 名男性，其中 224 名年龄较小。在年龄≤65 岁的男性中，PC 的发生率为 13.4%，而年龄较大的男性为 28.7%。年轻组中 Gleason 评分≥7 的比例较低（30%比 40%），pT1a 的比例较高（57%比 43%）。在年龄≤65 岁且患有癌症的男性中，30 例中有 15 例（50%）肿瘤仅在 1 个块中发现。诊断后，4/30 例接受根治性前列腺切除术，5/30 例接受根治性放疗，10/30 例接受雄激素剥夺治疗，1/30 例接受姑息性放疗。
结论
年龄≤65 岁男性偶然发现的 PC 并不少见。我们的结果表明，年龄≤65 岁男性的 TURP 标本应全面评估。由于激光前列腺切除术的广泛应用以及随之而来的组织丧失用于病理检查，可能会导致癌症的漏诊。
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