Shimazaki J, Higa T, Akimoto S, Masai M, Isaka S
Department of Urology, School of Medicine, Chiba University, Japan.
Adv Exp Med Biol. 1992;324:269-75. doi: 10.1007/978-1-4615-3398-6_29.
X-ray findings of bone metastatic lesions from 81 cases of stage D2 prostatic cancer were examined before and following endocrine therapy. Untreated lesions were classified into five types; osteoblastic (15%), mixed, but mainly osteoblastic (31%), mixed, but mainly osteolytic (17%), osteolytic (10%), and undetermined with a positive bone scan (27%). Patients with two mixed types had a tendency of widely speeded areas of metastasis and elevated serum prostatic acid phosphatase. Temporal enlargement of sclerotic lesion immediately after the start of therapy did not indicate disease progression. In many cases, changes from osteolytic to osteoblastic patterns were noticed in the same lesion regardless of the effects of endocrine therapy. Remodeling to the sclerotic pattern appeared as curative changes. From these findings, it was concluded that the natural course of bone lesions showed a tendency to change from the osteolytic to osteoblastic type and relapse was often accompanied by an increase of the osteolytic type lesion. Evaluation of therapeutic effects based on remodeling, changes in number and areas of lesions, and the appearance of new lesion correlated well with prognosis.
对81例D2期前列腺癌骨转移灶在内分泌治疗前后进行了X线检查。未经治疗的病灶分为五种类型：成骨型（15%）、混合型但以成骨为主（31%）、混合型但以溶骨为主（17%）、溶骨型（10%）以及骨扫描阳性但类型未确定（27%）。两种混合型患者有转移区域广泛扩散及血清前列腺酸性磷酸酶升高的倾向。治疗开始后不久硬化性病灶的暂时增大并不表明疾病进展。在许多病例中，无论内分泌治疗效果如何，同一病灶均可见从溶骨型向成骨型的转变。向硬化型的重塑表现为治愈性改变。根据这些发现得出结论，骨病灶的自然病程显示出从溶骨型向成骨型转变的倾向，复发常伴有溶骨型病灶增加。基于重塑、病灶数量和面积的变化以及新病灶的出现对治疗效果进行评估与预后密切相关。
