Willems J S, Löwhagen T
Prostate. 1981;2(4):381-95. doi: 10.1002/pros.2990020406.
In this article, the Karolinska experience of transrectal fine-needle aspiration biopsy of prostatic carcinoma, which now extends over more than twenty years, is evaluated. The cytologic criteria for diagnosing prostatic carcinoma in aspirates are well defined. While accuracy for cytodiagnosis is similar to that of histopathologic diagnosis, fine-needle aspiration is a less traumatic, cheaper procedure compared with histologic biopsy methods. Accuracy depends very much upon the skill of the examiner taking the cell samples and on the alertness of the cytopathologist for possible diagnostic pitfalls. Cytologic grading of prostatic carcinoma into well, moderately, and poorly differentiated types has been shown to be correlated significantly not only to histopathologic grading, but also to clinical stage, response to hormonal therapy and survival. The degree of tumor differentiation is well reproduced by independent observers. Cytochemical parameters, such as DNA measurement, constitute a potential refinement of cytologic grading, especially in moderately differentiated carcinomas. In medical centers with long experience of fine-needle aspiration biopsy, the method has a central role in diagnosis and management of prostatic carcinoma, including posttherapy follow-up.
本文评估了卡罗林斯卡学院在前列腺癌经直肠细针穿刺活检方面超过20年的经验。细针穿刺抽吸物中前列腺癌的细胞学诊断标准明确。虽然细胞诊断的准确性与组织病理学诊断相似，但与组织活检方法相比，细针穿刺是一种创伤性较小、成本较低的操作。准确性在很大程度上取决于采集细胞样本的检查人员的技术以及细胞病理学家对可能的诊断陷阱的警觉性。前列腺癌的细胞学分级分为高分化、中分化和低分化类型，已证明不仅与组织病理学分级显著相关，而且与临床分期、激素治疗反应和生存率也显著相关。肿瘤分化程度能被独立观察者很好地再现。细胞化学参数，如DNA测量，构成了细胞学分级的潜在改进方法，特别是在中分化癌中。在有细针穿刺活检长期经验的医疗中心，该方法在前列腺癌的诊断和管理中，包括治疗后随访，发挥着核心作用。
