Voges G E, McNeal J E, Redwine E A, Freiha F S, Stamey T A
Division of Urology, Stanford University School of Medicine, California 94305-5118.
J Urol. 1992 Mar;147(3 Pt 2):858-63. doi: 10.1016/s0022-5347(17)37406-2.
Morphometric analysis was performed on 44 radical prostatectomy specimens for clinical stages A1 and A2 carcinoma of the prostate. The majority of stage A cancers (86%) were located in the transition zone of the prostate, while only 14% arose in the peripheral zone. The subclassification into stages A1 and A2 based on the percentage of cancer in the transurethral resection chips did not reliably distinguish those cancers of high volume (transurethral resection plus residual). All 6 cases with Gleason grade 4 elements in the transurethral resection chips had relatively high volume cancer. In 32 of the 44 cases (73%) unsuspected cancers unrelated to the tumor detected at transurethral resection were found in the radical prostatectomy specimen. Of these cancers 87% were nontransition zone tumors. Eight unsuspected cancers were larger than the stage A cancer but only 2 of them were larger than 1 cc. Post-resection serum prostate specific antigen (PSA) levels were elevated with increasing total residual cancer volume in the radical specimen. In 19 of 20 cases with a PSA of greater than 2.5 ng./ml. the total residual cancer volume was more than 0.9 cc, while in 7 of 8 with a PSA of less than 1 ng./ml. total residual tumor volume was lower than 0.4 cc.
对44例前列腺A1期和A2期癌根治性前列腺切除术标本进行了形态计量分析。大多数A期癌症（86%）位于前列腺移行区，而仅14%起源于外周区。根据经尿道切除碎片中癌的百分比将其分为A1期和A2期，并不能可靠地区分那些高体积癌（经尿道切除加残留）。经尿道切除碎片中有Gleason 4级成分的所有6例患者都有相对高体积的癌。在44例中的32例（73%）中，在根治性前列腺切除标本中发现了与经尿道切除时检测到的肿瘤无关的意外癌。这些癌中87%是非移行区肿瘤。8例意外癌大于A期癌，但其中只有2例大于1立方厘米。根治性标本中，切除后血清前列腺特异性抗原（PSA）水平随总残留癌体积增加而升高。在20例PSA大于2.5 ng/ml的患者中，有19例总残留癌体积超过0.9立方厘米，而在8例PSA小于1 ng/ml的患者中，有7例总残留肿瘤体积低于0.4立方厘米。
