前列腺癌的神经内分泌分化和粘液分化
前列腺肿瘤|癌,关键词：
关键词：前列腺肿瘤；癌
摘要 探讨前列腺癌的神经内分泌分化和粘液分化与肿瘤分化程度及预后的关系。采用组织化学和免疫组织化学方法对63例前列腺癌进行研究。其中腺癌60例(高分化11例，中分化14例，低分化17例，未分化18例)，粘液癌3例。对照组为良性前列腺增生症(BPH)21例。结果：CgA的检出率：BPH>癌旁组织>癌组织，并随癌组织分化程度的下降，其检出率逐渐下降。神经内分泌细胞(NEC)密度的统计却显示相反的结果：BPH<癌旁腺体<腺癌，并随分化程度的下降其密度逐渐增加，以未分化癌最高。一些腺癌的腺腔和癌细胞胞浆中见到粘液分布，其总量均少于病变组织的25%。本组前列腺腺癌伴粘液分化与其病变组织中NEC检出率呈正相关，而与NEC密度呈负相关关系。结果提示：前列腺在癌变过程中可向两个方向分化，却表现相似的对内分泌治疗不敏感，更差的预后和更高的死亡率。
Neuroendocrine differentiation andmucinous differentiation in prostatic adenocarcinoma
Jiang Changxin,Tan Yubin,Cao Mengxun.Department ofPathology,Tianjin Medical University,Tianjin 300070Abstract A morphologic study by means of histochemical andimmunohistochemical techniques was performed on 63 cases of prostatic adenocarcinoma,ofwhich 60 were adenocarcinima (highly differentiated 11,moderately differentiatied 14,lowdifferentiated 17,undifferentiated 18),the other 3 being mucinous adenocarcinoma.Thepositive rate of CgA was higher in benign hyperplasia prostatic tissue than that inparacancer and in the adenocarcinoma tissue.The density of NEC was the lowest in benignhyperplasia,inceasing as the degree of differentiation decreased,being the highest inundifferentiated carcinoma.The interesting thing was that mucinous differentiation couldbe seen in the cavity of carcinomatous glands and in the plasma of carcinoma cells in someof the prostatic adenocarcinoma.There was a positive correlation between the mucinousdifferentiation rate and the NEC positive rate,but not the NEC density.It was concludedthat the neuroendocrine differentiation and the mucinous differentiation might be two ofthe monitor indices in assessing the diagnosis and in predicting the treatment effect andprognosis in prostatic adenocarcinoma.
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