Montironi Rodolfo, Mazzucchelli Roberta, Santinelli Alfredo, Scarpelli Marina, Beltran Antonio Lòpez, Bostwick David G
Polytechnic University of the Marche Region, School of Medicine, Umberto I Hospital, Torrette, Ancona, Italy.
Hum Pathol. 2005 Jun;36(6):646-54. doi: 10.1016/j.humpath.2005.03.018.
There are limited data regarding the pathological features of incidentally detected prostate cancer. Examination of cystoprostatectomy specimens obtained during bladder cancer treatment affords a unique opportunity to examine incidentally detected prostate cancer and determine its relationship with clinically detected prostate cancer obtained during radical prostatectomy. We compared the pathological findings of incidentally detected prostate cancer in 132 consecutive cystoprostatectomy specimens from patients treated for bladder cancer with a consecutive series of 228 radical prostatectomy specimens from patients treated for prostate cancer. All specimens were totally embedded and whole-mounted. Karyometry was evaluated in select subsets of patients from the study groups. Incidentally detected cancer was found in 42% of cystoprostatectomy specimens, and the cancers were of lower Gleason score and lower pathological stage with fewer positive surgical margins than in clinically detected cancers in age-matched radical prostatectomies. High-grade prostatic intraepithelial neoplasia (PIN) was present in 82% of radical prostatectomy specimens, in 70% of cystoprostatectomies with incidentally detected prostate cancer, and in 54% of cystoprostatectomies without prostate cancer. Mean nuclear and nucleolar area was lower in incidentally detected cancer and PIN when compared with clinically detected cancer and PIN, respectively, similar to the results with proliferative indices. We conclude that incidentally detected cancer is less aggressive than clinically detected cancer.
关于偶然发现的前列腺癌的病理特征，相关数据有限。对膀胱癌治疗期间获取的膀胱前列腺切除标本进行检查，为研究偶然发现的前列腺癌并确定其与根治性前列腺切除术中临床检测到的前列腺癌之间的关系提供了独特的机会。我们将132例连续接受膀胱癌治疗患者的膀胱前列腺切除标本中偶然发现的前列腺癌的病理结果，与228例连续接受前列腺癌治疗患者的根治性前列腺切除标本进行了比较。所有标本均进行了完全包埋和整体制片。对研究组中部分患者亚组进行了核测量评估。在42%的膀胱前列腺切除标本中发现了偶然发现的癌症，与年龄匹配的根治性前列腺切除术中临床检测到的癌症相比，这些癌症的Gleason评分较低、病理分期较低且手术切缘阳性较少。82%的根治性前列腺切除标本、70%有偶然发现前列腺癌的膀胱前列腺切除标本以及54%无前列腺癌的膀胱前列腺切除标本中存在高级别前列腺上皮内瘤变（PIN）。与临床检测到的癌症和PIN相比，偶然发现的癌症和PIN的平均核面积和核仁面积分别较低，这与增殖指数的结果相似。我们得出结论，偶然发现的癌症比临床检测到的癌症侵袭性更小。
