HISTOPATHOLOGY, ENZYMATIC ANALYSIS AND PROGNOSIS

诊断病理学家面临的一个最重要的障碍， 化疗师和放射治疗师在评估任何试图 改变前列腺癌的自然史在于 任何可识别的前列腺增生患者亚组内的异质性 癌 目前，最广泛使用的预后预测因子是 Gleason分级系统;然而，肿瘤接受 相同的格里森等级可能在生存和生物学方面存在巨大差异， 肿瘤的行为。 初步研究表明， N-乙酰-β-D-氨基葡萄糖苷酶的B同工酶， 葡萄糖-6-磷酸脱氢酶和肌酸激酶BB同工酶 补充了这一组织病理学系统，用于预测 预后 此外，这些酶中的几种相互补充， Gleason's Grade的预测 在一个小系列的患者中， 仅仅几年，这些酶活性中的某些酶活性与 比格里森的生存分数高 这些酶的活性是 前列腺癌与前列腺增生的差异 （BPH）。 我们的目标是（1）确定是否酶活性， 前列腺癌患者的前列腺未受累部分 显示任何与前列腺癌相似的改变，（2） 前瞻性地测量从肿瘤中提取的这些酶的活性 一系列足够大的病人来测试他们的临床 有用性明确，和（3）确定其他生化表型 在预测预后中补充组织病理学数据的标志物 前列腺增生患者同质亚组的鉴定 carcinoma. 据我们所知，这是第一个 多个酶标记物似乎与缺乏 的治疗，使生活，虽然有几个发达，类似 系统存在于动物模型中。 大多数治疗决定 癌症患者的生存率是根据以下数据得出的： 初步诊断。 因此，从以下方面获取信息非常重要： 尽可能多的信息，可能是有用的原发性肿瘤， 评估其生物学潜力。 尽管许多出版的作品， 大鼠肝癌，所附的6份重印本首次证明， 任何人类原发性肿瘤中的酶活性可能更有指导意义 比组织学评估预测预后;如果在一个 更大的研究，这一发现将有助于“适当分层， 临床试验"

A most important obstacle facing the diagnostic pathologist, chemotherapist, and radiotherapist in the evaluation of any attempt to alter the natural history of prostatic carcinoma lies in the great heterogeneity within any recognizable subgroup of patients with prostatic cancer. Currently, the most widely used predictor of prognosis is the grading system of Gleason; however, individuals whose tumors receive identical Gleason's grades may differ enormously in survival and biological behavior of their tumors. Preliminary studies have shown that measurement of extracted arginase, B iso-enzyme of N-acetyl-Beta-D-glucosaminidase, glucose-6-phosphate dehydrogenase, and BB iso-enzyme of creatine kinase from tumor complements this histopathological system for prediction of prognosis. Moreover, several of these enzymes complement one another for prediction of Gleason's grade. In a small series of patients followed for only a few years, certain of these enzymatic activities correlate better than Gleason's grade with survival. Activities of these enzymes are different in prostatic carcinoma and prostates with benign hyperplasia (BPH). Our objectives are (1) to determine if enzymatic activities in uninvolved portions of prostates from patients with prostatic carcinoma show any alterations similar to those seen in prostatic carcinoma, (2) prospectively to measure activities of these enzymes extracted from tumors of a series of patients sufficiently large to test their clinical usefulness definitively, and (3) to identify other biochemical phenotypic markers that complement histopathological data in prediction of prognosis and identification of homogeneous subgroups of patients with prostatic carcinoma. To our knowledge, this is the first human tumor for which multiple enzymatic markers appear to correlate with survival in the absence of therapy that prolongs life, although several well developed, analogous systems exist in animal models. Most therapeutic decisions that affect survival of patients with cancer are made based on data available at initial diagnosis. Consequently, it is of great importance to obtain from primary tumor as much information as possible that might be useful for the assessment of its biological potential. Despite much published work with rat hepatomas, the enclosed 6 reprints are the first demonstration that enzymatic activities in any human primary tumor may be more instructive than histological evaluation for prediction of prognosis; if confirmed in a larger study, this finding will facilitate "appropriate stratification in clinical trials."