Hollenbeck B K, Bassily N, Wei J T, Montie J E, Hayasaka S, Taylor J M, Rubin M A
Departments of Surgery, Section of Urology, Pathology and Biostatistics, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
J Urol. 2000 Nov;164(5):1583-6.
The optimal method to process radical prostatectomy specimens to maximize the detection of adverse pathological features is unclear and accurate staging is critical. We compare the ability of whole mounted sections to detect these features compared to partially submitted radical prostatectomy specimens.
A total of 93 consecutive radical prostatectomy specimens were processed as whole mounts. Tissue sections were analyzed and the pathological outcomes measured included Gleason score, surgical margin status, and presence or absence of extraprostatic tumor extension and/or seminal vesicle invasion. The pathological outcomes of the preceding cohort were compared to those of a similar cohort consisting of 554 men whose radical prostatectomy specimens were processed as partially submitted glands.
A multivariate logistic regression analysis was performed to determine the effect of the method of tissue processing on the pathological outcomes. When considered alone or adjusted for various preoperative patient characteristics (prostate specific antigen, biopsy Gleason score and clinical stage), there were no significant differences in the ability of whole mounted specimens to detect the various outcomes compared to partially submitted specimens (all p >0.4).
Whole mounted sampling of the radical prostatectomy specimen does not improve detection of adverse pathological features.
目前尚不清楚处理根治性前列腺切除术标本以最大程度检测不良病理特征的最佳方法，且准确分期至关重要。我们比较了完整切片与部分送检的根治性前列腺切除术标本在检测这些特征方面的能力。
共对93例连续的根治性前列腺切除术标本进行完整切片处理。对组织切片进行分析，测量的病理结果包括 Gleason 评分、手术切缘状态以及是否存在前列腺外肿瘤延伸和/或精囊侵犯。将前一组的病理结果与由554名男性组成的类似队列的结果进行比较，该队列的根治性前列腺切除术标本为部分送检腺体。
进行多因素逻辑回归分析以确定组织处理方法对病理结果的影响。单独考虑或针对各种术前患者特征（前列腺特异性抗原、活检 Gleason 评分和临床分期）进行调整后，完整切片标本与部分送检标本在检测各种结果的能力方面无显著差异（所有p>0.4）。
根治性前列腺切除术标本的完整切片取样并不能提高对不良病理特征的检测。
