Phenotypic heterogeneity of end-stage prostate carcinoma metastatic to bone
Phenotypic heterogeneity of end-stage prostate carcinoma metastatic to bone
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DOI：
10.1016/s0046-8177(03)00190-4
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发表时间：
2003-07-01
期刊：
影响因子：
3.3
通讯作者：
Vessella, RL
中科院分区：
文献类型：
--
作者：
Roudier, MP;True, LD;Vessella, RL
为了更好地了解终末期雄激素非依赖性前列腺癌（Cap）的临床和病理特征，我们对14例死于进展性前列腺癌的男性进行了快速尸检，并记录了相关的临床资料。肿瘤进展的时间差异很大。雄激素独立的中位时间为2年（范围4个月至13.6年）。雄激素独立后的中位生存期为1年（1个月至3.6年）。由于骨转移在进展性Cap中很普遍，因此在每个患者中系统地取样了多达20个骨部位。骨转移广泛；肿瘤平均在14个骨位填充骨髓。在所有转移瘤中检测肿瘤组织学、前列腺特异性抗原（PSA）和嗜铬粒蛋白A （CGA）的表达，并与原发肿瘤进行比较。观察到转移瘤的5种组织学类型：实体瘤（10例）、大腺泡瘤（1例）、微腺泡瘤（1例）、透明细胞瘤（1例）和粉刺癌（1例）。原发肿瘤的格里森分级不能预测转移灶的组织学类型。虽然70%的肿瘤细胞表达PSA，但在一些患者的独立转移中，PSA阳性细胞的比例差异很大（标准差>25）。同样，不同转移灶中神经内分泌（NE） （cga阳性）肿瘤细胞的比例差异很大。例如，在1例患者中，0 - 95%的不同转移灶的肿瘤细胞具有NE表型。本研究强调了转移性Cap在组织学和免疫表型上的异质性。因此，由于表型异质性，针对I转移的治疗可能对同一患者的其他转移没有影响。(C) 2003 Elsevier Inc.版权所有。
To better understand the clinical and pathologic features of end-stage, androgen-independent carcinoma of the prostate (Cap), we performed rapid autopsies on 14 men who died of progressive Cap and recorded relevant clinical data. The timing of tumor progression varied widely. The median time to androgen independence was 2 years (range, 4 months to 13.6 years). The median survival after androgen independence was I year (range, I month to 3.6 years). Because osseous metastases are prevalent in progressive Cap, up to 20 bone sites were systematically sampled in each patient. Bone metastases were widespread; tumor filled the marrow in an average of 14 bone sites. Tumor histology and expression of prostate-specific antigen (PSA) and chromogranin A (CGA) were examined in all metastases and were compared with the primary tumor. Five histological patterns of metastatic tumor were observed: solid (10 patients), macroacinar (1 patient), microacinar (I patient), clear cell (I patient), and comedocarcinoma (1 patient). Gleason grade of the primary tumor did not predict the histological pattern of the metastases. Although >70% of tumor cells expressed PSA, the fraction of PSA-positive cells varied widely in separate metastases in some patients (standard deviation >25). Likewise, the fraction of neuroendocrine (NE) (CGA-positive) tumor cells in different metastases varied widely. For example, between 0 and 95% of tumor cells in different metastases in I patient had a NE phenotype. The present study highlights the heterogeneity-histologically and immunophenotypically of metastatic Cap. Consequently, therapy directed to the phenotype of I metastasis may have no effect on other metastases in the same patient because of phenotypic heterogeneity. (C) 2003 Elsevier Inc. All rights reserved.