Combined histologic grading of prostatic carcinoma
Combined histologic grading of prostatic carcinoma
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前列腺癌的联合组织学分级
作者：
A. Böcking;Joachim Kiehn;Monika Heinzel‐Wach
本文提出了一种新的前列腺癌组织学分级系统，并对其临床意义进行了检验。其中发现的组织生长类型和核间变相互独立地进行评估。诊断类别与世界卫生组织最近公布的组织学分类一致。29肿瘤按分化程度最低的部分命名。区分了三种级别的恶性肿瘤，它们对应着显著不同的生存概率。与同年龄段的健康男性相比，1级患者的预后并不降低。1级患者未发现转移。肿瘤特异性死亡率随肿瘤恶性程度的升高而增加。观察者间该分级的重复性被发现为91%。对于5%的欠评，代表性被发现是令人满意的。前列腺癌往往会及时改变其恶性程度。讨论了临床早期的I级前列腺癌患者能否从治疗中受益的问题。
A new histologic grading system for prostatic adenocarcinomas is presented, and its clinical significance tested. Histologic growth patterns and nuclear anaplasia found therein are evaluated independently of each other. The diagnostic categories are in accordance with the histologic classification recently published by the WHO.29 The tumor is denominated according to the least differentiated fraction. Three grades of malignancy, which correspond to significantly different survival probabilities, are distinguished. The prognosis of grade 1 patients is not reduced in comparison to that of healthy males of the same age. Grade 1 patients did not reveal metastases. The rate of tumor‐specific deaths increases with the malignancy grade of the tumor. Interobserver reproducibility of this grading is found to be 91%. With 5% undergradings, the representativity is found to be satisfactory. Prostatic carcinomas tend to change their malignancy grades in time. The question of whether grade I prostatic carcinoma patients with early clinical stages benefit from therapy is discussed.