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目的探讨前列腺萎缩后增生(PAH)的病理形态学特征和鉴别诊断。方法收集前列腺PAH标本11例,选择34βE12、p63、P504S、PSA和PSAP抗体检测,观察其病理形态学特点和免疫组化表达特点。结果11例PAH患者均来自临床诊断为良性前列腺增生的手术切除标本,经进一步病理检查发现有PAH病灶,与正常前列腺相比,11例均可见增多的大小不一的腺泡,其中包括囊状扩张的大腺泡和似增生样结构的小腺泡。“增生”的腺泡体积较小、排列密集,其中2例小腺泡周围可见基底细胞,9例基底细胞难以明确。“增生”的小腺泡需要与癌性腺泡鉴别,这些腺泡边缘34βE12或p63(+),结合上皮细胞P504S(-)可明确诊断;3例小腺泡上皮PSA和PSAP(+)弱于周围萎缩的腺上皮细胞。11例均有间质纤维增生和淋巴细胞浸润,其中1例边缘伴有上皮内瘤,2例伴有腺瘤样增生。结论前列腺PAH是较少见的前列腺瘤样病变,在HE切片中易误诊为前列腺癌。基底细胞标记物34βE12、p63和癌性上皮标记物P504S联合应用对前列腺PAH的诊断具有价值。
Objective To investigate the pathological features and differential diagnosis of prostatic aplasia (PAH). Methods Eleven patients with PAH were collected. 34βE12, p63, P504S, PSA and PSAP antibodies were detected. The pathological features and immunohistochemical characteristics of PAH were observed. Results All the 11 patients with PAH were from the surgically diagnosed benign prostatic hyperplasia (HIP). After further pathological examination, PAH lesions were found. Compared with the normal prostate, all the 11 patients showed increased size of acinar, including cystic Dilated large acini and small hyperplasia like alveoli. “Hyperplasia ” acinar volume smaller, arranged in dense, including 2 cases of small acinar around the basal cells, 9 cases of basal cells is difficult to clear. Small hyperplasia of acne need to be distinguished from cancerous acini. These acinar margins can be clearly diagnosed by 34βE12 or p63 (+) combined with epithelial cell P504S (-). Three cases of small acinar epithelial PSA and PSAP (+), Weaker than surrounding atrophic glandular epithelial cells. Eleven cases had interstitial fibrosis and lymphocytic infiltration, including one with marginal edge of intraepithelial neoplasia, and two with adenomatous hyperplasia. Conclusions Prostate PAH is a rare type of prostate tumor-like lesions that is often misdiagnosed as prostate cancer in HE slices. The combination of basal cell markers 34βE12, p63 and the marker of cancerous epithelium P504S is of value in the diagnosis of PAH in the prostate.