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目的 探讨前列腺原发性印戒细胞癌的组织发生、病理特征和鉴别诊断。方法 在2 62例经穿刺活检证实的前列腺癌中选出 10例印戒细胞癌 ,用SP法作前列腺特异性抗原 (PSA)、前列腺酸性磷酸酶 (PAP)、雄激素受体 (AR)等 9种免疫组织化学标记和AB/PAS ,黏液卡红染色 ,3例作电镜观察 ,并与 10例胃肠道印戒细胞癌作比较。结果 10例中仅 1例为纯印戒细胞癌 ,9例与经典型前列腺癌混合 ,印戒细胞癌成分均大于癌总量的 2 5 %。按形态特征和形成机制 ,可将印戒细胞分为胞质内空泡或内腔形成和胞质内PSA、PAP分泌物积聚二种类型 ,二种类型印戒细胞均缺乏胞质内黏液 ,故不同于消化道印戒细胞癌。结论 原发性印戒细胞癌是来自前列腺腺泡上皮的低分化特殊组织学类型腺癌。在穿刺活检中可以与来自消化道 ,泌尿道的浸润性或转移性印戒细胞癌鉴别 ,也不同于放疗或内分泌治疗后经典型前列腺癌的空泡变性
Objective To investigate the histopathological features and differential diagnosis of primary signet ring cell carcinoma of the prostate. Methods Twenty-two cases of signet ring cell carcinoma were selected from 626 cases of prostate cancer confirmed by biopsy. PSA was used as prostate-specific antigen (PSA), prostatic acid phosphatase (PAP) and androgen receptor (AR) Nine kinds of immunohistochemical markers and AB / PAS, mucin card red staining, three cases for electron microscopy, and with 10 cases of gastrointestinal signet ring cell carcinoma for comparison. Results Only one of 10 cases was pure signet ring cell carcinoma, and 9 cases were mixed with classical prostate cancer. The components of signet ring cell carcinoma were all more than 25% of the total cancerous cells. According to morphological characteristics and formation mechanism, signet ring cells can be divided into two types: cytoplasmic vacuoles or cavity formation and intracytoplasmic PSA and PAP secretion accumulation. Both types of signet ring cells lack cytoplasm, It is different from the gastrointestinal signet ring cell carcinoma. Conclusions Primary signet-ring cell carcinoma is a poorly differentiated, histologically-specific adenocarcinoma of the prostate acinar epithelium. In biopsy can be from the digestive tract, urinary tract invasive or metastatic signet ring cell carcinoma identification, is also different from the radiotherapy or endocrine therapy after the classic prostate cancer vacuolar degeneration