沿前列腺大导管生长的原发性尿路上皮癌一例

摘要

原发性前列腺尿路上皮癌是一种少见的前列腺原发性肿瘤.该文报道了一例沿前列腺大导管生长的原发性尿路上皮癌.该患者以排尿及夜尿增多2年为主诉,经完善检查后行经尿道前列腺等离子切除术.术后病理可见前列腺组织内大片明显异型的短梭形细胞构成的巢团,核分裂可见,少量区域可见细胞团内坏死.免疫组织化学检查示细胞角蛋白7 (CK7)、CK20及高分子量角蛋白(CKH)弥漫阳性,CK5/6 及 P63 部分阳性,增殖指数 Ki-67 约30%阳性,前列腺特异抗原、P504s阴性表达.病理诊断为前列腺原发的尿路上皮癌.术后膀胱内灌注吡柔比星化学治疗1 个周期(每周1 次,连续6次).随访近1 年患者恢复良好.原发性前列腺尿路上皮癌的预后与临床分期及病理分级相关,外科手术是延长患者生命的有效方法,辅助化学治疗可改善早期患者的预后.%Primary urothelial carcinoma of the prostate is a rare primary prostate tumor. In this arti-cle,we reported one case of primary urothelial carcinoma of the prostate which grew along with the large duct of the prostate. The patient reported the chief complaints of increased urination and nocturia for two years. He un-derwent transurethral plasmakinetic resection of the prostate after comprehensive examinations. Postoperative pathological examination of the prostate tissues showed a large mass consisting of distinctly shaped short-spindle cells exhibiting mitotic activity. In a small area,necrosis of the cell mass was observed. Immunohistochemical staining demonstrated that the cytokeratin 7 (CK7),cytokeratin 20 (CK20)and high molecular weight keratin (CKH)were diffusely positive,the cytokeratin 5/6 (CK5/6)and P63 were partially positive,the proliferation index Ki-67 was approximately 30% positive,whereas the prostate specific antigen (PSA)and P504s were negative. He was pathologically diagnosed with primary urothelial carcinoma of the prostate. Postoperatively, one cycle of chemotherapy with intravesical instillation of pirarubicin was performed once a week for 6 consecu-tive times. He was well recovered during nearly one year of follow-up. The clinical prognosis of primary urothe-lial carcinoma of the prostate is associated with clinical staging and pathological grading. Surgery is an effective way to prolong the life of patients,and adjuvant chemotherapy can enhance the clinical prognosis of patients with early-stage primary urothelial carcinoma of the prostate.