摘要
目的:提高对低分化膀胱癌和前列腺癌的诊治水平。方法:回顾性分析3例通过形态学观察不能明确肿瘤组织来源的低分化膀胱肿瘤和前列腺肿瘤病人的临床和病理资料,并采用免疫组织化学的方法检测PSA、CK7、CK20、34βE12在该3例中的表达情况。结果:病例1,于右输尿管口的位置可见广基性占位病变,共3个,大小约1.5 cm×1.5 cm,临床考虑为尿路上皮来源肿物,病检为膀胱低分化癌呈腺样分化倾向,免疫组化显示PSA+++,CK7、CK20、34βE12均为-,证实肿瘤来源于前列腺组织;病例2,DRE示前列腺Ⅱ°增大,坚硬如石,表面有结节。病检为前列腺低分化腺癌,脉管内可见瘤栓,不能除外尿路上皮源性肿物,免疫组化显示PSA、34βE12为-,CK7+++、CK20+++,证实肿瘤为尿路上皮来源;病例3,于膀胱颈处可见不规则赘生组织。病检为低分化癌,脉管内可见瘤栓,未见典型腺样结构,但某处可见腺样分化倾向,局部有移行上皮分化倾向,免疫组化示PSA、CK20-,CK7+++、34βE12++,证实肿瘤来源于尿路上皮。结论:PSA、CK7、CK20、34βE12这一组抗体可以帮助鉴别低分化膀胱癌和前列腺癌。免疫组织化学技术对于确定形态学上难以明确诊断的膀胱和前列腺低分化癌的组织来源具有重要的临床价值。
Objective： To improve the diagnosis and treatment of poorly differentiated bladder tumors and prostate tumors which were morphologically difficult diagnosis. Methods： The clinical and pathologic data of 3 patients with poorly differentiated bladder carcinoma or prostate carcinoma of morphologically difficult diagnosis were reviewed, and the method of immunohistochemistry was used to detect the expression of PSA, CK7, CK20, 34βE12 in these 3 cases. Results： Case one, there were three lesions on the location of right ureteral orifice, which were clinically suspected as papillary urothelial neoplasms, but pathological study showed poorly differentiated adenocarcinoma of bladder, and immunohistochemical analysis showed intensely positive for PSA, but negative for CKT, CK20, 34βE12, so based on the pathological and immunohistochemical findings, a diagnosis that the neoplasm of bladder originated from prostate gland was made; Case two, patient had hyperplasia in prostate gland and pathological study showed poorly differentiated adenocarcinoma of prostate but could not except the urothelial origin. Immunohistochemical analysis showed negative for PSA and 34βE12,but intensely positive for CK7 and CK20, so a diagnosis that the neoplasm originated from urothelium was made. Case three, the cystoscopy revealed an irregular lesion at the bladder neck, and pathological study showed poorly differentiated carcinoma which had no typical glandular pattern and focal lesion suspected to be of urothelial origin. Immunohistochemical analysis showed negative for PAS and CK20, but positive for CK7 and 34βE12, so a diagnosis that the neoplasm originated from urothelium was made. Conclusion： A panel of antibodies： PSA, CK7, CK20, 3413E12 can assist in distinction of poorly differentiated bladder carcinoma from prostate carcinoma. The technique of immunohistochemistry is very important in determining the origin of poorly differentiated bladder tumors and prostate tumors which were morphologically difficult diagnosis.
出处
《天津医科大学学报》
2008年第4期548-551,共4页
Journal of Tianjin Medical University
关键词
免疫组织化学
膀胱癌
前列腺癌
Immunohistochemistry
Bladder carcinoma
Prostatic carcinoma
