Stromogenic prostatic carcinoma pattern (carcinomas with reactive stromal grade 3) in needle biopsies predicts biochemical recurrence-free survival in patients after radical prostatectomy
Stromogenic prostatic carcinoma pattern (carcinomas with reactive stromal grade 3) in needle biopsies predicts biochemical recurrence-free survival in patients after radical prostatectomy
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DOI：
10.1016/j.humpath.2007.04.008
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发表时间：
2007-11-01
期刊：
影响因子：
3.3
通讯作者：
Ayala, Gustavo E.
中科院分区：
文献类型：
--
作者：
Yanagisawa, Nobuyuki;Li, Rile;Ayala, Gustavo E.
我们之前报道过，根治性前列腺切除术中的反应性基质分级是复发的预测因素，并且与反应性基质分级1和2相比，反应性基质分级0和3与较低的生化无复发生存率相关。我们探讨了术前针活检中反应性基质分级的预后意义。贝勒医学院通过针吸活检诊断出 224 例前列腺癌。根据先前描述的标准，在苏木精-伊红 (H&E) 染色切片上评估反应性基质分级：0 级，具有 0% 至 5% 反应性基质； 1级，6%至15%； 2级，16%至50%； 3 级，51% 至 100%，或腺体和间质之间的比例至少为 1:1。使用 Kaplan-Meier 和 Cox 比例风险分析。反应性基质分级分布如下：反应性基质分级0、1例（0.5%）；反应性基质分级1，149例（66.5%）；反应性基质分级2级，59例（26.3%）；反应性基质分级3级15例（6.7%）。活检中的反应性基质分级与前列腺切除术中的不良临床病理参数相关。反应性基质分级为 I 和 2 的患者比 0 和 3 级患者的生存率更高 (P = .0034)。反应性基质分级是复发的独立预测因子（风险比 = 1.953；P = .0174）。在格里森评分为 7 的患者中，反应性基质分级与格里森 4 + 3 和 3 + 4 无关。对反应性基质进行定量并识别 H&E 染色活检中的基质癌，可用于预测前列腺癌患者的生化复发，而与格里森分级和前列腺特异性抗原无关。 (c) 2007 年，爱思唯尔公司出版。
We previously reported that reactive stromal grading in radical prostatectomies is a predictor of recurrence and that reactive stromal grading 0 and 3 are associated with lower biochemical recurrence-free survival rates than reactive stromal grading 1 and 2. We explored the prognostic significance of reactive stromal grading in preoperative needle biopsies. At Baylor College of Medicine, 224 cases of prostatic carcinoma were diagnosed by needle biopsy. Reactive stromal grading was evaluated on hematoxylin-eosin (H&E)-stained sections on the basis of previously described criteria: grade 0, with 0% to 5% reactive stroma; grade 1, 6% to 15%; grade 2, 16% to 50%; grade 3, 51% to 100%, or at least a 1:1 ratio between glands and stroma. Kaplan-Meier and Cox proportional hazard analyses were used. Reactive stromal grading distribution was as follows: reactive stromal grading 0, 1 case (0.5%); reactive stromal grading 1, 149 cases (66.5%); reactive stromal grading 2, 59 cases (26.3%); reactive stromal grading 3, 15 cases (6.7%). Reactive stromal grading in biopsies was correlated with adverse clinicopathologic parameters in the prostatectomy. Patients with reactive stromal grading I and 2 had better survival than those with 0 and 3 (P = .0034). Reactive stromal grading was an independent predictor of recurrence (hazard ratio = 1.953; P = .0174). Reactive stromal grading is independent of Gleason 4 + 3 and 3 + 4 in patients with a Gleason score of 7. Quantitation of reactive stroma and recognition of the stromogenic carcinoma in H&E-stained biopsies is useful to predict biochemical recurrence in prostate carcinoma patients independent of Gleason grade and prostate-specific antigen. (c) 2007 Published by Elsevier Inc.