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遗传性前列腺癌中的筛状癌和导管内癌:20例临床病理分析

Cribiform and intraductal carcinoma in hereditary prostate cancer: clinical and pathological analysis of 20 cases.

作者信息

Zhang Yuhao, Zhang Yutao, Shi Minjing, Liu Xiaoyan, Zhang Han, Zhao Ping, Ren Guoping

机构信息

Department of Pathology, The First Hospital of Zhejiang University School of Medicine Hangzhou, Zhejiang, China.

出版信息

Am J Clin Exp Urol. 2024 Apr 15;12(2):100-109. doi: 10.62347/XOIN3964. eCollection 2024.

Abstract

Cribiform and intraductal carcinoma are patterns of aggressive prostate carcinoma. This study investigated the clinical and pathological features of hereditary prostate cancer. Twenty cases of hereditary prostate cancer from 11 family lines treated at the First Affiliated Hospital of Zhejiang University School of Medicine between 2016-2022 were included to summarize the clinical and pathological features by analyzing clinical information including follow up the survival of the patients and pathological features. Of the 20 hereditary prostate cancer cases, 19 were radical prostate specimens and 1 was a biopsy specimen. The mean age at diagnosis of the patients was 67.55 years and the mean PSA was 15.44 ng/ml, of which 10 cases had PSA ≥ 10 ng/ml and 5 cases had PSA ≥ 20 ng/ml. Of the 19 radical prostate specimens, Gleason cribriform pattern (Gleason grade 4) of PCa is observed in 15 cases (78.95%), and intraductal carcinoma, usually a rare form, is seen in 9 cases (47.3%). Two cases demonstrated pelvic lymph node metastasis, and 7 cases (35%) belonged to high-risk or very high-risk PCa. One case (5.26%) showed partial deletion of expression of RB1, and 13 cases (68.42%) showed deletion of expression of PTEN. Follow-up was 4-90 months, 2 cases had biochemical recurrence and 1 case died from prostate cancer. The mean age at diagnosis of this group of patients with hereditary prostate cancer was 67.55 years, the mean preoperative PSA was 15.44 ng/ml, and their histomorphology was characterized by a high percentage of intraductal carcinoma and cribriform pattern of the prostate.

摘要

筛状癌和导管内癌是侵袭性前列腺癌的病理类型。本研究调查了遗传性前列腺癌的临床和病理特征。纳入了2016年至2022年间在浙江大学医学院附属第一医院接受治疗的来自11个家系的20例遗传性前列腺癌患者,通过分析包括患者生存随访在内的临床信息和病理特征,总结其临床和病理特征。在这20例遗传性前列腺癌病例中,19例为前列腺根治标本,1例为活检标本。患者的平均诊断年龄为67.55岁,平均前列腺特异性抗原(PSA)为15.44 ng/ml,其中10例PSA≥10 ng/ml,5例PSA≥20 ng/ml。在19例前列腺根治标本中,15例(78.95%)观察到前列腺癌的筛状模式(Gleason分级4级),9例(47.3%)出现通常较为罕见的导管内癌。2例出现盆腔淋巴结转移,7例(35%)属于高危或极高危前列腺癌。1例(5.26%)显示RB1表达部分缺失,13例(68.42%)显示PTEN表达缺失。随访时间为4至90个月,2例出现生化复发,1例死于前列腺癌。这组遗传性前列腺癌患者的平均诊断年龄为67.55岁,术前平均PSA为15.44 ng/ml,其组织形态学特征为导管内癌和前列腺筛状模式的比例较高。

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