RELATIONSHIP BETWEEN CLINICAL STAGE AND HISTOLOGICAL ZONE OF ORIGIN IN EARLY PROSTATE-CANCER - MORPHOMETRIC ANALYSIS

被引:56
作者
GREENE, DR
WHEELER, TM
EGAWA, S
WEAVER, RP
SCARDINO, PT
机构
[1] BAYLOR COLL MED,SCOTT DEPT UROL,6560 FANNIN,SUITE 1004,HOUSTON,TX 77030
[2] BAYLOR COLL MED,DEPT PATHOL,HOUSTON,TX 77030
[3] METHODIST HOSP,UROL SERV,HOUSTON,TX 77030
[4] METHODIST HOSP,PATHOL SERV,HOUSTON,TX 77030
来源
BRITISH JOURNAL OF UROLOGY | 1991年 / 68卷 / 05期
关键词
D O I
10.1111/j.1464-410X.1991.tb15394.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
A detailed morphometric analysis of 96 radical prostatectomy specimens (13 clinical stage A1, 29 A2, 34 B1 and 20 B2) was undertaken to examine the relationship of zone of origin to volume, grade and extraprostatic extension of cancer. In patients with stage A disease, transition zone (TZ) cancer (present in 81%) was significantly larger but of lower grade than peripheral zone (PZ) cancer (present in 90%). The total volume of cancer in stage A1 patients averaged 1.55 ml with 72% of TZ origin. In patients with stage A2 disease, tumour volume averaged 5.83 ml with only 57% of TZ origin. Specimens taken during transurethral resection of the prostate (TURP) revealed TZ cancer in 82% and PZ cancer either alone or with TZ cancer in 22%. The 9 patients with PZ cancer in the TURP specimen included 5 of the 11 with extracapsular extension and all 5 of those with seminal vesicle invasion. Every patient with stage B disease had PZ cancer which, in all except 3 cases, was of significantly larger volume and higher grade than any TZ cancer (present in 43%) in the same gland. In patients with stage B cancer, total tumour volume was 5.13 ml with 91% of PZ origin. TZ cancer tended to be well differentiated in all patients, even at large volumes, whereas PZ cancer was often moderately or poorly differentiated even at low volumes. In patients with stage B disease, TZ cancer appeared to be incidental and of no clinical importance, while in stage A patients PZ cancers were sometimes large, poorly differentiated and extended outside the prostate. Progression of a stage A cancer seems more likely to result from PZ cancer than TZ cancer, and the finding of PZ cancer in a TURP specimen should probably preclude its classification as stage A1.
引用
收藏
页码:499 / 509
页数:11
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