【摘要】 目的　探讨前列腺癌放疗和内分泌治疗后的组织学效应及其临床意义。方法　 2 2例前列腺癌治疗后 4～ 36月作 1～ 2次穿刺活检复查。将治疗前后组织学形态和免疫组化改变作对比分析。对残余癌的治疗效应进行分级并作随访。结果　治疗后残余癌检出率 5 9% ,13例有残余癌病例中 ,5例重度、5例中度、2例轻度治疗效应。有 3例治疗后活检发现无明显治疗效应的癌灶 ,4例单纯内分泌治疗病例疗效明显比合并放疗者差。残余癌PCNA表达下降与治疗效应增强有相关性。同时 ,良性前列腺组织也产生一系列治疗诱导的形态改变。结论　为防止误诊和不适当的组织学分级 ,病理医师应熟悉前列腺癌治疗后的形态改变 ,对有残余癌的病例应作效应评级。检查是否存在无明显治疗效应的癌灶 ,以区分阳性活检中的治疗成功者和失败者 ,从而为临床进一步治疗和判断预后提供依据。更多还原

【Abstract】 Purpose To study histologic effect and clinical significance of prostate carcinoma after radiotherapy and endocrine therapy. MethodsAfter therapy from 4～36 months, 22 cases of prostate carcinoma were examined in needle biopsy, pathologic and immunohistochemical changes were analysed by comparison of those between before and after therapies. ResultsAfter therapy 13 cases (59%) were detected remanent carcinoma, in which 5 cases were high degree of therapy effect, 5 cases were medium and 2 cases were mild. Three cases were detected carcinoma of no effect of therapy, the curative effect in 4 cases of pure endocrine therapy was poor, comparing with cases with combined raidotherapy. There was an association between increase of curative effect and decrease of PCNA expression. After therapy there were also morphologic changes in benign acini and stroma, which originated from therapy. Conclusions Pathologist should well know pathologic changes of prostate carcinoma after therapy in order to avoid misdiagnosis and mis evaluating degree of histology. Pathologist should also grade the therapy effect of remanent carcinoma and examine whether there is the carcinoma that has not curative effect, to differntiate decide the therapy will be success or failure.更多还原