MORPHOLOGY OF PROSTATE-CANCER - THE EFFECTS OF MULTIFOCALITY ON HISTOLOGICAL GRADE, TUMOR VOLUME AND CAPSULE PENETRATION
MORPHOLOGY OF PROSTATE-CANCER - THE EFFECTS OF MULTIFOCALITY ON HISTOLOGICAL GRADE, TUMOR VOLUME AND CAPSULE PENETRATION
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DOI：
10.1016/s0022-5347(17)32368-6
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发表时间：
1994-11-01
影响因子：
6.6
通讯作者：
CYGAN, JM
中科院分区：
文献类型：
--
作者：
MILLER, GJ;CYGAN, JM
对一系列 151 个根治性前列腺切除术标本进行了整体分析。检查的特征包括组织学分级、肿瘤体积、病理阶段和多灶性。只有 43.7% 的前列腺含有单个癌，31.1% 有 2 个独立的病灶，其余 25.2% 含有 3 至 6 个肿瘤。平均体积最小的肿瘤中多灶性最大。所有级别均发现体积小于 3 cc 的肿瘤（格里森总和为 2 至 10）。体积最大的肿瘤是中等级别的肿瘤（格里森总计为 4 至 8）。在体积小于 1 cc 的肿瘤中，70% 局限于前列腺包膜内，其格里森总和为 4 或更小。然而，侵入前列腺包膜的体积小于 3 cc 的肿瘤几乎均等地分为 2、3 或 4 的格里森总和和 5、6 或 7 的格里森总和。虽然检查每个前列腺最大肿瘤的研究表明组织学分级和体积密切相关，但我们的结果表明情况不一定如此。此外，很明显，肿瘤在具有局部侵袭性之前不需要获得大体积或高级别。因此，前列腺癌患者的预后预测可能很大程度上受到肿瘤多灶性的影响。
A series of 151 radical prostatectomy specimens were subjected to whole-mount analysis. Features examined included histological grade, tumor volume, pathological stage and multifocality. Only 43.7% of the prostates contained a single carcinoma, 31.1% had 2 separate foci and the remaining 25.2% contained 3 to 6 tumors. Multifocality was greatest among tumors with the lowest mean volumes. Tumors with volumes of less than 3 cc were found in all grades (Gleason sums of 2 through 10). The highest volume tumors were those of intermediate grade (Gleason sums 4 through 8). Among tumors with volumes of less than 1 cc 70% that were confined within the prostatic capsule had Gleason sums of 4 or less. However, tumors with volumes of less than 3 cc that had invaded through the prostatic capsule were nearly equally divided between Gleason sums of 2, 3 or 4 and those of 5, 6 or 7.While studies examining the largest tumor per prostate have suggested that histological grade and volume are closely related, our results indicate that this is not necessarily the case. Furthermore, it is clear that tumors need not acquire either large volume or high grade before they can become locally invasive. It is likely, therefore, that the prediction of prognosis for patients with prostatic cancer is greatly influenced by tumor multifocality.