A critical analysis of tumor morphology and hormone treatments in the untreated and estrogen‐treated responsive and refractory human prostatic carcinoma
A critical analysis of tumor morphology and hormone treatments in the untreated and estrogen‐treated responsive and refractory human prostatic carcinoma
复制标题
对未经治疗和雌激素治疗的反应性和难治性人类前列腺癌的肿瘤形态和激素治疗的批判性分析
作者：
A. A. Sinha;C. Blackard;U. Seal
本研究旨在比较未经治疗和雌激素治疗的反应性和难治性患者中前列腺癌细胞的超微结构特征。对以前未经治疗和雌激素治疗的癌症的分析表明，肿瘤具有分化良好和分化不良的腺泡和侵袭性细胞。恶性腺泡中含有大量柱状（分泌）细胞在未经治疗的，但很少在治疗的个人。在未处理和处理的腺泡中观察到两种不同类型的基底细胞：I型（亮）和II型（暗）细胞。在未处理和处理的肿瘤中，I型细胞的特征在于具有圆形核，具有许多常染色质、大核仁和电子透明核质的小聚集体。II型细胞具有高度多形性的核、折叠的核膜-有时在局部区域缺乏、常染色质、许多异染色质的小聚集体、大的多形性核仁和相对电子不透明的核质。在某些切片中，两种类型的基底细胞均穿透腺泡基底层并具有侵袭性。前列腺癌，或随后成为难治性雌激素显示更丰富的II型基底细胞比响应患者。据推测，II型基底细胞以及一些I型基底细胞从一开始就是内分泌无反应的。此外，肿瘤具有异质性癌细胞群体。虽然雄激素依赖性肿瘤细胞如柱状细胞可能被内分泌治疗破坏，但这些内分泌无反应细胞继续增殖，转移并杀死患者。因此，我们建议晚期前列腺癌患者最初可以给予内分泌治疗，以减少内分泌敏感细胞引起的肿瘤负荷。此外，在这些细胞系有机会增殖并发展成难治性癌之前，可以使用化疗或放疗的早期治疗来破坏无反应的内分泌不敏感细胞。Cancer 40：2836 - 2850，1977.
This study was done to compare the ultrastructural features of prostatic cancer cells in both untreated and estrogen‐treated responsive and refractory patients. Analysis of previously untreated and estrogen‐treated carcinomas showed that the tumors possessed well‐ and poorly‐differentiated acini, and invasive cells. Malignant acini contained numerous columnar (secretory) cells in untreated, but few in treated individuals. Two distinct types of basal cells were observed in untreated and treated acini: type I (light) and type II (dark) cells. In both untreated and treated tumors, type I cells were characterized by having round nuclei with many small aggregates of euchromatin, large nucleoli, and electron‐lucent nucleoplasm. The type II cells had highly pleomorphic nuclei, folded nuclear envelope—sometimes deficient in localized areas, euchromatin, many small aggregates of heterochromatin, large pleomorphic nucleoli, and relatively electron‐opaque nucleoplasm. In some sections, both types of basal cells penetrated through the acinar basal lamina and became invasive. Prostatic carcinomas which were or subsequently became refractory to estrogens showed more abundant type II basal cells than responsive patients. It is postulated that the type II basal cells as well as some type I basal cells are endocrine unresponsive from the outset. Furthermore the tumor possesses a heterogeneous population of cancer cells. While androgen‐dependent tumor cells such as columnar cells may be destroyed by endocrine therapy, these endocrine unresponsive cells continue to proliferate, metastasize, and kill the patient. Therefore, we suggest that patient with advanced prostatic carcinoma initially may be given endocrine therapy to reduce tumor burden caused by endocrine‐sensitive cells. In addition, early treatment with chemotherapy or radiation may be used to destroy unresponsive endocrine‐insensitive cells, before these cells lines have a chance to proliferate and to develop into refractory carcinoma. Cancer 40:2836‐2850, 1977.