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目的:探讨前列腺特殊类型癌(PPTC)病理变化、免疫组化表达特点。方法:采用HE及免疫组化方法观察27例PPTC形态学特征。结果:(1)移行细胞癌及鳞癌具有典型的形态,癌细胞无PSA及35βH11表达,cerbB2显阳性。从形态分析,这两种癌可能同源于移行上皮或化生上皮:(2)粘液腺癌、黄色瘤样癌、导管癌、髓样癌、宫内膜样癌、乳头状癌及印戒细胞癌均显PSA及35βH11阳性,提示这几种癌可能来源于分泌上皮;(3)类癌对PSA、35βH11、NSE及CgA均显阳性,符合内分泌细胞来源;(4)小细胞癌无PSA、NSE及CgA表达,对cerbB2及35βH11显阳性,是否来源于前列腺内分泌细胞、储备细胞或基细胞有待证实;(5)27例癌区均无34βE12表达,提示PPTC中基细胞缺失。结论:PPTC少见,组织类型多,形态各异及不同的免疫组化表达,有时诊断较困难,应注意鉴别。
Objective: To investigate the pathological changes and immunohistochemical features of special type of prostate cancer (PPTC). Methods: The morphological features of 27 cases of PPTC were observed by HE and immunohistochemistry. Results: (1) Transitional cell carcinoma and squamous cell carcinoma have the typical morphology, the expression of PSA and 35βH11 is not found in cancer cells, and cerbB2 is positive. Morphologically, both cancers may be homologous to transitional or metaplastic epithelia: (2) mucinous adenocarcinomas, xanthomatous carcinomas, ductal carcinomas, medullary carcinomas, endometrial carcinomas, papillary carcinomas and signet rings (3) Carcinoid carcinoma was positive for PSA, 35βH11, NSE and CgA, which was consistent with the origin of endocrine cells; (4) Small cell carcinoma without PSA , NSE and CgA expression of c erbB 2 and 35βH11 was positive, whether derived from the prostate endocrine cells, reserve cells or basal cells to be confirmed; (5) 27 cases of cancer were not 34βE12 expression, suggesting that PPTC basal cell loss . Conclusion: PPTC rare, many types of tissues, different forms and different immunohistochemical expression, sometimes more difficult to diagnose, should pay attention to identify.