Prospective characterization of pathological features of prostatic carcinomas detected via serum prostate specific antigen based screening
Prospective characterization of pathological features of prostatic carcinomas detected via serum prostate specific antigen based screening
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DOI：
10.1016/s0022-5347(01)66316-x
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发表时间：
1996-03-01
影响因子：
6.6
通讯作者：
Catalona, WJ
中科院分区：
文献类型：
--
作者：
Humphrey, PA;Keetch, DW;Catalona, WJ
目的：许多小的（小于0.5 cc），分化良好，器官局限性前列腺癌在患者的生活中临床上未被发现，只有在尸检时才被发现。因此，这些癌症通常被称为潜伏性或尸检癌症。值得关注的是，基于血清前列腺特异性抗原（PSA）的筛查可能会优先检测这些癌症。有有限的前瞻性数据有关的病理特征的前列腺癌检测的筛查计划。我们确定，如果通过PSA为基础的筛查类似尸检cancer.Materials和方法：我们评估了100个连续的，完全嵌入式根治性前列腺切除术标本中的癌症的病理特征，从男性的癌症检测在PSA为基础的筛查程序。肿瘤的病理分期，手术切缘状态，Gleason组织学分级和腺内肿瘤程度（形态定量为癌和肿瘤体积的百分比）进行了评估。结果：100例癌68例（68%）大于0.5立方厘米的体积（平均1.7，范围0.1至10.7）。手术标本中癌的平均数量为10.3%（范围0.1至41.6%）。在100例癌中，94例的Gleason评分为5 - 8（平均5.7），只有6例（6%）分化良好（Gleason评分为4或更低）。在41例（41%）中发现局部晚期疾病，判断存在囊外癌和/或癌性手术margin.Conclusions：我们的结论是，大多数前列腺癌的病理特征检测通过PSA为基础的筛选不像尸检癌症，大多数前列腺癌检测的筛选程序可能是临床上重要的。
Purpose: Many small (less than 0.5 cc), well differentiated, organ-confined prostate carcinomas remain clinically undetected during the life of the patient and are identified only at postmortem examination. Thus, these cancers are often called latent or autopsy cancers. There is concern that serum prostate specific antigen (PSA) based screening may preferentially detect these cancers. There are limited prospective data concerning the pathological features of carcinomas of the prostate detected in a screening program. We determined if prostatic carcinomas detected via PSA based screening resembled autopsy cancers.Materials and Methods: We assessed the pathological features of carcinomas in 100 consecutive, completely embedded radical prostatectomy specimens from men whose cancer was detected in a PSA based screening program. The tumors were evaluated for pathological stage, surgical margin status, Gleason histological grade and intraglandular tumor extent (morphometrically quantified as percentage carcinoma and tumor volume).Results: Of 100 carcinomas 68 (68%) were larger than 0.5 cc in volume (mean 1.7, range 0.1 to 10.7). Mean amount of carcinoma in the surgical specimen was 10.3% (range 0.1 to 41.6). Of the 100 carcinomas 94 had a Gleason score of 5 to 8 (mean 5.7) and only 6 (6%) were well differentiated (Gleason score of 4 or less). Locally advanced disease was noted in 41 cases (41%) as judged by the presence of extracapsular carcinoma and/or cancerous surgical margins.Conclusions: We concluded that the pathological features of most prostatic carcinomas detected via PSA based screening do not resemble those of autopsy cancers, and that most prostatic cancers detected in screening programs are likely to be clinically important.