摘要目的 分析和总结成人前列腺肉瘤的临床和病理特征,以提高对前列腺肉瘤的认识和诊断水平.方法 收集15例前列腺肉瘤患者的临床和病理资料,对标本进行病理形态学观察,免疫组织化学采用EnVision法染色.并对治疗和预后进行总结分析.结果 患者发病年龄22～77岁,平均46.3岁；多数以排尿困难就诊,并且直肠指检和影像学可发现占位体积较大；15例前列腺肉瘤中,平滑肌肉瘤6例,胚胎性横纹肌肉瘤6例,纤维肉瘤3例.随访12例,其中7例术后9 ～360 d死亡,尚存5例随访2～24个月,其中3例目前出现肿瘤复发.结论前列腺肉瘤罕见,发病年龄偏早,尿路症状出现较快,血清中前列腺特异性抗原水平正常或偏低,占位效应明显,预后差.最终诊断依靠HE形态和免疫组织化学的表达.

abstractsObjective To clarify the clinical and morphological features of adult prostate sarcoma (APS) and to further improve the knowledge and diagnostic accuracy for APS.Methods Fifteen cases of APS were observed and analyzed on the clinical symptom,pathological features,treatment and prognosis.Results Age of onset ranged from 22 to 77 years ( mean 46.3 years).The majority of cases were presented with dysuresia.By digital rectal examination and imaging of the prostate,APS was often identified as a large tumor mass.There were 6 cases of leiomyosarcomas,6 embryonal rhabdomyosarcomas,and 3 fibrosarcomas in this series.Follow-up data were available for 12 cases:7 cases died of the disease between 9 days and 360 days after surgery.Among 5 survived patients,3 cases had recurrence after 2 to 24 months follow-up.Conclusions APS is a rare tumor that typically has clinical features:earlier age of onset,fast-appeared urinary tract symptoms,significant mass effects,and poor outcome.Level of prostate specific antigen (PSA)is usually normal or lower.Final diagnosis relies on the features of histology and immunohistochemistry expression profile.