前立腺肥大症に対する経尿道的切除術標本よりの前立腺偶発癌の診断法

概要

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BPHとしてTURされた647例の内,全chipの組織学的検索でA癌の発見された58例(9.0%)を対象として,A癌診断のための組織検索方法について検討した.1) A癌59例は病巣が限局性で高分化型のA1 40と,病巣が瀰漫性に広がるか低分化型のA2 19であった.2)切除重量10 g未満のBPHにA癌合併率が高く,重量増加に従い合併率は低下した.3) A癌全例の検索スライド数と癌が存在したスライド数より確率を算出した結果,95%の確率でA癌診断可能の検索スライド数はA2で2枚,A1で6枚(平均切除重量15 g)であった.4) A癌診断のためBPHのTUR標本の組織学的検査は,6枚までのスライド,切除重量15 gでほぼ十分と考えたThe amount of prostatic tissue necessary to detect carcinoma in transurethral resection specimens with reasonable accuracy, was evaluated. The samples were taken from the patients with a clinical diagnosis of benign prostatic hypertrophy. Prostate chips from 647 such patients were examined microscopically. An average of 2.5 g of sample was mounted in each block. Adenocarcinoma was diagnosed in 58 cases (9.0%). Among them, 40 cases were in stage A1, and 18 in stage A2. Incidental carcinoma was found more frequently in prostate chips weighing less than 20 g. To detect carcinoma with 95% probability, at least 2 slides should be examined in stage A2, and 6 slides in stage A1.