Vollmer R T, Humphrey P A
Laboratory Medicine, Veterans Affairs Medical Center, Durham, NC 27705, USA.
Am J Clin Pathol. 2001 Dec;116(6):864-70. doi: 10.1309/7MQ7-MWAR-4W8A-R75F.
We report on how anatomic pathology observations and prostate-specific antigen (PSA) observations made before and just after radical prostatectomy relate to subsequent outcomes in men with prostate cancer. Our study patients consisted of more than 200 men who underwent radical prostatectomy and who had a mean follow-up of more than 6 years. We found that there were 2 categories of failures after surgery--one consisting of an eventual elevated PSA level and the other consisting of an early death from progressive tumor--and that these 2 failures related differently to PSA and anatomic pathology observations made at the time of prostatectomy. Whereas preoperative and postoperative levels of PSA related most closely to PSA failure, Gleason grade 5 and the percentage carcinoma related most closely to early death. Our results suggest how men could be sorted into 3 prognostic categories after surgery: one with high hazard for early death, a second with low hazard for early death but with high probability for eventual elevated PSA level, and a third with overall good prognosis.
我们报告了根治性前列腺切除术前后所做的解剖病理学观察和前列腺特异性抗原（PSA）观察与前列腺癌男性患者后续结局之间的关系。我们的研究患者包括200多名接受根治性前列腺切除术且平均随访时间超过6年的男性。我们发现术后有两类失败情况，一类是最终PSA水平升高，另一类是因肿瘤进展导致早期死亡，并且这两类失败情况与前列腺切除术时所做的PSA和解剖病理学观察的关联有所不同。术前和术后的PSA水平与PSA失败关联最为密切，而 Gleason 5级和癌组织百分比与早期死亡关联最为密切。我们的结果表明了术后男性如何可被分为3个预后类别：一类早期死亡风险高，另一类早期死亡风险低但最终PSA水平升高的可能性大，第三类总体预后良好。
