前列腺活检中的非典型的导管内扩散 - 一个诊断灰色地带,临床含义
Rui M Bernardino1,2, João Lobo3,4, Jihad Kaouk5
1Princess Margaret Cancer Centre, Division of Urology University of Toronto, Toronto, Ontario, Canada. ruimmbernardino@gmail.com.
Nature reviews. Urology
|November 7, 2025
概括
前列腺活检中的非典型导管内扩散 (AIP) 可能表明未采样的侵袭性癌症. 这种边缘性损伤需要进一步调查,以准确地分层和管理前列腺癌风险.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 病理学 病理学 病理学
- 在瘤学瘤学.
背景情况:
- 非典型的导管内扩散 (AIP) 是前列腺活检中具有挑战性的边界病变.
- 它的诊断标准位于高度前列腺内皮质瘤和导管内癌 (IDC) 之间.
研究的目的:
- 重新评估AIP在前列腺癌风险分层中的临床意义和作用.
- 探索AIP作为隐性攻击性疾病的潜在标志物.
主要方法:
- 从前性和分子研究中对新出现的证据进行审查.
- 对AIP与导管内癌 (IDC) 和不良病理特征的关联进行分析.
- 研究AIP和IDC之间共享的分子变化的研究.
主要成果:
- AIP是未采样IDC和不良病理发现的强有力的预测指标.
- AIP经常与中等风险的前列腺癌共存.
- AIP与IDC具有相同的分子变化,包括PTEN损失和ERG过度表达.
结论:
- AIP可能作为隐性侵袭性前列腺癌的标志物.
- 了解AIP的影响对于精确诊断和主动监控策略至关重要.
- 需要进一步的研究来澄清AIP在前列腺癌管理中的最终作用.
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