경직장초음파유도 전립샘침생검 1,000예의 병리학적 검색: 새로운 검체처리 방법의 수립 및 면역조직화학검사의 유용성 평가
Pathological Analysis of 1,000 Cases of Transrectal Ultrasound-guided Systematic Prostate Biopsy: Establishment of New Sample Processing Method and Diagnostic Utility of Immunohistochemistry
현창림, 이희은, 김혜령, 이혜승, 박소연, 정진행, 최기영,
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현창림 ( Hyun Chang-Lim )
서울대학교 의과대학 병리학교실
이희은 ( Lee Hee-Eun )
서울대학교 의과대학 병리학교실
김혜령 ( Kim Hae-Ryung )
서울대학교 의과대학 병리학교실
이혜승 ( Lee Hye-Seung )
서울대학교 의과대학 병리학교실
박소연 ( Park So-Yeon )
서울대학교 의과대학 병리학교실
정진행 ( Chung Jin-Haeng )
서울대학교 의과대학 병리학교실
최기영 ( Choe Ghee-Young )
서울대학교 의과대학 병리학교실
KMID : 0357920060400060406
Abstract
Background: We developed a new processing method for extended prostate needle biopsy, and evaluated diagnostic utility of routine immunohistochemistry in 1,000 consecutive unselected cases of transrectal ultrasound-guided systematic prostate biopsy.
Methods: Four to five biopsy cores were embedded in one paraffin block. All the biopsy cores were immunohistochemically stained with basal cell markers.
Results: The new sample processing method was technically perfect for making a diagnosis from extended prostate needle biopsy. Among 1,000 cases, there were 323 cases (32.3%) of adenocarcinoma, 5 cases of other malignant tumors, 9 cases of high-grade prostatic intraepithelial neoplasia without a carcinoma, and only 8 cases of atypical small acinar proliferation. Among the 323 cases of adenocarcinoma, there were 38 cases (11.8%) of microcarcinomas <0.1 cm and 101 cases (31.3%) of small adenocarcinomas <0.3 cm in length. In the needle biopsy specimens, 59 cases (18.3%) were classified as clinically insignificant carcinomas. Among them, 37 cases underwent radical prostatectomy, which turned out to be clinically significant carcinomas in 24 cases (64.9%).
Conclusions: Routinely performed immunohistochemistry combined with the new sample processing method is very effective for detecting microscopic carcinoma foci as well as differentiating carcinoma from benign conditions mimicking cancer.
키워드
Prostate;Prostatic neoplasms;Needle biopsy;Immunohistochemistry
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