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目的 探讨临床A期前列腺癌的病理特征 ,并分析其好发部位及漏诊误诊原因。方法 复查上海地区 5所医院 10 2 0份前列腺切除标本 ,通过免疫组织化学SP法检出 5 0例临床A期前列腺癌 ,根据肿瘤分化程度及容量分出A1期癌 12例和A2期癌 38例 ,比较病理形态差异 ,分析A1和A2期癌的漏诊误诊原因。结果 A1期癌以低中级别、低容量、多灶性生长为特点 ,A2期癌以高中级别、高容量、高浸润性伴高级别上皮内新生物为特征。在漏诊误诊的 8例A期癌中 ,A1期癌占 7例 ,均误诊为良性增生性小腺泡病变。A2期癌 1例误诊为反应性上皮样组织细胞增生。结论 A1期癌大多在增生的前列腺移行带和中央带组织易被发现 ,A2期癌可能是大多原发于周围带的高中级别癌浸润至前列腺中央区域。国内A期癌检出率低的原因主要是因为标本取材量少和A1期癌漏诊率较高。
Objective To investigate the clinical features of clinical stage A prostate cancer and analyze its causes of misdiagnosis and misdiagnosis. Methods 102 cases of prostatectomy in 5 hospitals in Shanghai area were retrospectively reviewed. Fifty cases of clinical stage A prostate cancer were detected by immunohistochemical SP method. 12 cases of stage A1 carcinoma and 12 cases of stage A2 carcinoma were divided according to tumor differentiation degree and capacity Cases, comparison of pathological differences, analysis of misdiagnosis of A1 and A2 cancer misdiagnosis. Results Stage A1 carcinoma was characterized by low-grade, low-volume and multifocal growth. Stage A2 carcinoma was characterized by high-grade intraepithelial neoplasia with high-grade, high-volume, high-infiltrating sexual partners. Misdiagnosis in missed diagnosis of 8 cases of A cancer, A1 cancer accounted for 7 cases were misdiagnosed as benign prostatic hyperplasia of small acinar lesions. One case of stage A2 carcinoma was misdiagnosed as reactive epithelioid cell hyperplasia. Conclusions Most of the A1 carcinomas are easily found in the proliferative transitional zone of the prostate and the central zone. The carcinoma of the A2 stage may be mostly infiltrating into the central region of the prostate. The reason for the low detection rate of A-stage cancer in China is mainly because of the lack of samples and the missed diagnosis rate of A1-stage carcinoma.