Adenocarcinoma on needle prostatic biopsies: Does reactive stroma predicts biochemical recurrence in patients following radical prostatectomy?
Adenocarcinoma on needle prostatic biopsies: Does reactive stroma predicts biochemical recurrence in patients following radical prostatectomy?
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DOI：
10.1590/s1677-5538.ibju.2013.03.04
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发表时间：
2013-06-01
影响因子：
3.7
通讯作者：
Ferreira, Ubirajara
中科院分区：
文献类型：
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作者：
Billis, Athanase;Meirelles, Luciana;Ferreira, Ubirajara
目的：有证据表明，反应性基质在不同的肿瘤中可能调节肿瘤的进展。本研究的目的是建立前列腺穿刺活检反应性基质分级与生化复发之间的关系。材料和方法：研究组包括266例连续接受根治性前列腺切除术的患者的活检。反应性间质定义为肿瘤组织周围的间质，根据肿瘤间质面积相对于肿瘤总面积分为0（无）、1（轻微）、2（中度）和3（强烈）。结果266例前列腺穿刺活检中，0、1、2、3级分别为143例（53.8%）、55例（20.7%）、54例（20.3%）、14例（5.3%）。升高的反应性间质分级与临床T2分期、术前PSA升高、活检和根治性前列腺切除术Gleason评分升高、根治性前列腺切除术肿瘤范围扩大、病理分期> T2显著相关。只有3级与时间和生化复发风险显著相关。在多变量分析中，只有术前PSA和两种活检肿瘤范围评估方法是独立的预测因素。结论：活检中反应性间质分级的增加与一些临床病理不良结果显著相关，然而，在单因素分析中，只有3级可以预测根治性前列腺切除术后生化复发的时间和风险，而在多因素分析中则不能。我们无法证明活组织检查的反应性基质3级是生化复发的独立预测因子，而术前PSA和活检的其他病理结果除外。
Objective: There is evidence that reactive stroma in different cancers may regulate tumor progression. The aim of this study is to establish any possible relation of reactive stroma grading on needle prostatic biopsies to biochemical recurrence.Materials and Methods: The study group comprised 266 biopsies from consecutive patients submitted to radical prostatectomy. Reactive stroma was defined as stroma surrounding neoplastic tissue and graded as 0 (absent), 1 (slight), 2 (moderate), and 3 (intense) according to tumor stroma area relative to total tumor area.Results: From the total of 266 needle prostatic biopsies, 143 (53.8%), 55 (20.7%), 54 (20.3%), and 14 (5.3%) showed grades 0, 1, 2, and 3, respectively. Increasing reactive stroma grade was significantly associated with clinical stage T2, higher preoperative PSA, higher biopsy and radical prostatectomy Gleason score, more extensive tumors in radical prostatectomy, and pathologic stage > T2. Only grade 3 was significantly associated with time and risk to biochemical recurrence. On multivariate analysis only preoperative PSA and 2 methods of biopsy tumor extent evaluation were independent predictors.Conclusion: Increasing reactive stroma grade on biopsies is significantly associated with several clinicopathologic adverse findings, however, only grade 3 predicts time and risk to biochemical recurrence following radical prostatectomy on univariate but not on multivariate analysis. We have not been able to show that reactive stroma grade 3 on biopsies is an independent predictor of biochemical recurrence beyond that of preoperative PSA and other pathologic findings on biopsy.