INTRAGLANDULAR TUMOR EXTENT AND PROGNOSIS IN PROSTATIC-CARCINOMA - APPLICATION OF A GRID METHOD TO PROSTATECTOMY SPECIMENS
INTRAGLANDULAR TUMOR EXTENT AND PROGNOSIS IN PROSTATIC-CARCINOMA - APPLICATION OF A GRID METHOD TO PROSTATECTOMY SPECIMENS
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DOI：
10.1016/0046-8177(90)90048-a
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发表时间：
1990-08-01
期刊：
影响因子：
3.3
通讯作者：
VOLLMER, RT
中科院分区：
文献类型：
--
作者：
HUMPHREY, PA;VOLLMER, RT
应用网格法对117例前列腺癌切除标本进行了肿瘤范围的测定。使用具有3.0 mm正方形的塑料条或直尺，并计算覆盖癌的正方形与覆盖前列腺组织的正方形总数的比率。该网格比率代表肿瘤累及前列腺的百分比估计值，是与肿瘤进展的可能性和生存时间密切相关的重要指标，如通过逻辑回归分析和比例风险模型评估的。在预测肿瘤进展和患者生存方面，网格比率优于组织学分级;而且，观察者间一致性值判断，该比率比组织学分级更客观。同时使用范围和等级仅获得轻微的改善。网格比率法在预测肿瘤进展和患者生存方面略优于第二种评估肿瘤累及前列腺组织百分比的方法，即病理学家的百分比估计值。这些结果表明，它是重要的定量肿瘤范围内的前列腺切除术标本，这种定量不需要整个前列腺和一个昂贵的和耗时的方法，如计算机形态学的逐步切片，而是可以通过一个简单的估计肿瘤所涉及的前列腺的百分比进行。建议报告前列腺的组织学分级和肿瘤范围，因为这两者对于识别前列腺癌行直肠切除术后预后不良的风险患者非常重要。
The extent of tumor in prostatectomy specimens was determined by a grid method in 117 patients with prostatic adenocarcinoma. A plastic strip or ruler with squares of 3.0 mm was used, and the ratio of squares overlying carcinoma to the total number of squares overlying prostate tissue was calculated. This grid ratio, which represents an estimate of the percentage of the prostate involved by tumor, was a significant prognosticator closely tied to the likelihood of tumor progression and to survival time, as assessed by logistic regression analysis and a proportional hazard model. The grid ratio was better than histologic grade in predicting tumor progression and patient survival; also, the ratio was more objective than histologic grade as judged by interobserver agreement values. Only slight improvemetn in prognostication was obtained with concurrent use of both extent and grade. The grid ratio method was slightly better in predicting tumor progression and patient survival than a second method of assessing the percentage of prostatic tissue involved by tumor, the pathologist''s percentage estimate. These results indicate that it is important to quantitate tumor extent within prostatectomy specimens; such quantitation need not require step-sectioning of the entire prostate and an expensive and time-consuming method such as computerized morphometrics but rather may be performed by a simple estimate of the percentage of the prostate involved by tumor. Reporting of histologic grade and tumor extent in the prostate gland is recommended as both appear to be important in identifying those patients at risk for a poor outcome after prostatectomy for prostatic cacinoma.