Henneberry J M, Kahane H, Humphrey P A, Keetch D W, Epstein J I
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Am J Surg Pathol. 1997 Jun;21(6):725-8. doi: 10.1097/00000478-199706000-00014.
Based on data from autopsy, radical prostatectomy, and cystoprostatectomy specimens, it has been suggested that the finding of intraluminal crystalloids in benign glands on needle biopsy may indicate a concurrent carcinoma; therefore, repeat biopsy is recommended. We studied data from 56 consecutive needle biopsies from the Johns Hopkins Hospital and Dianon Systems in which the diagnosis of intraluminal crystalloids in benign glands was rendered and follow-up data were subsequently obtained. Cases in which crystalloids were present in glands suspicious for cancer, in glands of high-grade prostatic intraepithelial neoplasia, or in adenosis were excluded from the study. Follow-up data included repeat biopsy results and serum prostatic specific antigen levels. Of the 56 men, 31 (55%) had repeat biopsy (two underwent transurethral resection of the prostate [TURP]); the remaining men were either noncompliant or had medical conditions precluding subsequent biopsy. Of the 31 men who underwent repeat biopsies, 23 (74%) had benign diagnoses, one (3%) had high-grade prostatic intraepithelial neoplasia, and seven (23%) had adenocarcinoma. There was no difference in serum prostate-specific antigen values between those with and without cancer on repeat biopsy. In a control population of men with a benign first biopsy not showing crystalloids, the incidence of cancer on repeat biopsy was 16.2%, which was not statistically significantly different from the incidence found in our study group. We conclude that men with prostate biopsy results showing benign glands with crystalloids are at no significantly higher risk of having cancer on repeat biopsy than if crystalloids were not present.
基于尸检、根治性前列腺切除术及膀胱前列腺切除术标本的数据，有人提出针吸活检时在良性腺体中发现管腔内晶体可能提示同时存在癌；因此，建议重复活检。我们研究了来自约翰霍普金斯医院和戴安诺系统公司的56例连续针吸活检的数据，这些活检做出了良性腺体中存在管腔内晶体的诊断，随后获得了随访数据。将晶体存在于可疑癌症的腺体、高级别前列腺上皮内瘤变的腺体或腺病的腺体中的病例排除在研究之外。随访数据包括重复活检结果和血清前列腺特异性抗原水平。56名男性中，31名（55%）进行了重复活检（2名接受了经尿道前列腺切除术[TURP]）；其余男性要么不配合，要么有医疗状况妨碍随后的活检。在接受重复活检的31名男性中，23名（74%）诊断为良性，1名（3%）为高级别前列腺上皮内瘤变，7名（23%）为腺癌。重复活检时有癌和无癌者的血清前列腺特异性抗原值无差异。在首次活检为良性且未显示晶体的男性对照人群中，重复活检时癌症的发生率为16.2%，与我们研究组的发生率无统计学显著差异。我们得出结论，前列腺活检结果显示良性腺体伴有晶体的男性，重复活检时患癌风险并不比不存在晶体时显著更高。
