前立腺穿刺吸引細胞診の有用性の検討

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臨床的に前立腺癌が疑われる患者および前立腺癌のため治療中の患者計143名に対し経直腸的前立腺穿刺吸引細胞診と,経会陰式針生検による病理組織診を行った.1)吸引細胞診の検体採取率は,針生検による組織標本採取率と同等であり,92.3%であった.中でも未治療前立腺癌の検体採取率は95.8%と高かった.2)前立腺癌56例における吸引細胞診の正診率は75.0%であり,分化度が低いほどfalse negativeは少ない傾向にあった.良性前立腺癌疾患におけるfalse positiveは4.8%であった.3)前立腺癌に対する治療が奏効していると考えられる20例中,治療後の細胞診は高分化型は全例陰性,中等度分化型は12例中5例陽性,低分化型は全例陽性であった.治療効果なしの4例は全例陽性であった.4) 182回の前立腺吸引生検による合併症は1件も認めなかったThe aspiration biopsy of the prostate for cytological detection was evaluated in 143 patients with clinically suspected prostate cancer and compared with the pathological diagnosis by needle biopsy performed simultaneously. Histopathological evaluation was possible in 136 cases. Sufficient cells for cytological diagnosis were obtained in 92.3% of pathologically diagnosed cases. Only 3 specimens for cytology (4.3%) of the prostate cancer before treatment were insufficient for cytology. Compared with pathological diagnosis by needle biopsy, false positive and negative rates were observed in 4.8% and 25.0% respectively. The accuracy rate of cytological diagnosis was higher the higher the degree of anaplasia in the pathological findings. In 20 clinically well-controlled patients the cytological results were negative in all of the well differentiated adenocarcinomas, whereas positive in poorly differentiated ones without exception. The cytological findings were still positive in all of the 4 cases with progressive cancer in spite of the anticancer therapy. Besides these results, because of no complication in the 182 aspiration biopsies, this may be a useful method for detection of prostate cancer, especially for screening of the cancer and judgment of efficacy during treatment.

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藤本佳則
大垣市民病院泌尿器科

前立腺穿刺吸引細胞診の有用性の検討

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