False-Negative Histopathologic Diagnosis of Prostatic Adenocarcinoma
False-Negative Histopathologic Diagnosis of Prostatic Adenocarcinoma
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DOI：
10.5858/arpa.2019-0456-ra
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发表时间：
2020-03-01
影响因子：
4.6
通讯作者：
Humphrey, Peter A.
中科院分区：
文献类型：
--
作者：
Yang, Chen;Humphrey, Peter A.
背景：前列腺癌的组织病理学诊断是基于苏木精-伊红染色的组织切片的光镜检查。多种因素，包括分析前和分析要素，影响病理学家准确诊断前列腺癌的能力。假阴性诊断，即未能诊断前列腺癌，可能会造成严重的临床后果。描述和理解那些可能影响和引起前列腺癌组织病理学假阴性诊断的因素是很重要的。目的：回顾前列腺癌组织病理学漏诊的常见因素，包括：(1)组织处理和切片伪影，(2)微型腺癌，(3)看起来像是良性的腺泡腺癌变种，(4)单细胞腺癌，和(5)治疗效果。同行评议的文献和资深作者的亲身经历。结论-了解前列腺癌的组织病理学假阴性诊断的原因是前列腺癌诊断评估的重要组成部分。对小腺癌(微小)的组织形态表现的诊断意识；看似良性的变异体，包括萎缩性、泡沫状腺、微囊性和假性增生性变异体；单细胞癌；以及治疗效果对于建立明确的腺癌诊断和防止前列腺癌的假阴性诊断至关重要。
Context.-Histopathologic diagnosis of adenocarcinoma of the prostate is based on light-microscopic examination of hematoxylin-eosin-stained tissue sections. Multiple factors, including preanalytic and analytic elements, affect the ability of the pathologist to accurately diagnose prostatic adenocarcinoma. False-negative diagnosis, that is, failure to diagnose prostatic adenocarcinoma, may have serious clinical consequences. It is important to delineate and understand those factors that may affect and cause histopathologic false-negative diagnoses of prostatic adenocarcinoma.Objectives.-To review common factors involved in histopathologic underdiagnosis of prostatic adenocarcinoma, including the following: (1) tissue processing and sectioning artifacts, (2) minimal adenocarcinoma, (3) deceptively benign appearing variants of acinar adenocarcinoma, (4) single cell adenocarcinoma, and (5) treatment effects.Data Sources.-Data sources included published, peer-reviewed literature and personal experiences of the senior author.Conclusions.-Knowledge of the reasons for histopathologic false-negative diagnosis of adenocarcinoma of the prostate is an important component in the diagnostic assessment of prostate tissue sections. Diagnostic awareness of the histomorphologic presentations of small (minimal) adenocarcinoma; deceptively benign appearing variants including atrophic, foamy gland, microcystic, and pseudohyperplastic variants; single cell carcinoma; and treatment effects is critical for establishment of a definitive diagnosis of adenocarcinoma and the prevention of false-negative diagnoses of prostate cancer.