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在患有前列腺癌的男性中,癌症进展的生物学决定因素
T A Stamey1, J E McNeal, C M Yemoto
1Department of Urology, School of Medicine, Stanford University, Calif, USA. tstamey@leland.stanford.edu
前列腺癌的进展与高级癌症的百分比 (格里森4/5级) 和瘤体积有关. 精确测量这些因素对于预测患者疾病进展至关重要.
科学领域:
- 在瘤学瘤学.
- 尿路病理学 尿路病理学
- 手术病理学手术病理学
背景情况:
- 增加前列腺腺癌的诊断能力带来了治疗决策的挑战.
- 准确预测前列腺癌的进展对于有效的患者管理至关重要.
研究的目的:
- 研究前列腺癌进展与修改的格里森分级系统之间的关联.
- 确定预测疾病进展的形态和临床变量.
主要方法:
- 对379名患有外围区域前列腺癌的男性进行了回顾性分析,这些男性接受了激进前列腺切除术.
- 评估了8个形态变量,包括格里森4/5级,癌症体积,血管入侵和淋巴结参与.
- 生物化学进展通过增加血清前列腺特异性抗原 (PSA) 水平来定义.
主要成果:
- 格里森4/5级的百分比 (%格里森4/5级) 和癌症体积高度预测癌症的进展.
- 积极的淋巴结发现和前列腺内血管入侵也是显著的预测因素.
- 传统的格里森得分,囊透率和积极的外科手术边缘并不是失败的独立预测因素.
结论:
- %格里森等级4/5,癌症体积,阳性淋巴结和前列腺内血管侵袭独立地与前列腺癌的进展有关.
- 需要精确的癌症体积和格里森等级4/5的测量技术来改善预测.
- 已确定的预测因素,如囊透率和积极的外科手术边缘,在急性前列腺切除术后没有独立的预测价值.
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