Greene D R, Taylor S R, Wheeler T M, Scardino P T
Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030.
Cancer Res. 1991 Aug 1;51(15):4084-9.
The malignant potential of an individual focus of prostate cancer is difficult to determine. The established pathological features associated with malignant behavior include tumor volume, grade, and invasiveness (local extension or metastasis). We used nuclear image analysis to determine the DNA ploidy value of each cancer in a series of 30 radical prostatectomy specimens from patients with early stage prostate cancer in order to further explore the malignant potential of each separate focus of cancer. The volume, grade, invasiveness (extracapsular extension or seminal vesicle invasion), and zone of origin of each of the 63 separate cancers were determined. The DNA ploidy histogram of 200 cancer cells was compared with 50 normal epithelial nuclei on the same Feulgen-stained tissue sections. Sixty % of the cancers were diploid, and 40% were nondiploid. Ploidy correlated with volume and grade. All cancers less than 0.02 cm3 were diploid; 26% of foci 0.02 to 2.0 cm3 and 82% of foci greater than 2.0 cm3 were nondiploid. There were 16 cancers of transition zone origin ranging in size from 0.02 to 12.1 cm3 and only one (7.3 cm3) was nondiploid. There were 47 cancers of peripheral zone origin (range, 0.01 to 18.98) and 24 (51%) were nondiploid. Eight of the 24 nondiploid cancers were small (less than 1.0 cm3), and two were only 0.03 cm3. We conclude that some very small prostate cancers are nondiploid and that progression of prostate cancer is not a function of volume alone, whereby tumors only acquire full malignant potential at large volumes. Cancers of peripheral zone origin acquire a nondiploid cell population at a smaller volume than do cancers of transition zone origin, further supporting a fundamental difference between cancers arising in these zones.
前列腺癌单个病灶的恶性潜能难以确定。与恶性行为相关的既定病理特征包括肿瘤体积、分级和侵袭性（局部扩展或转移）。我们采用核图像分析来测定一系列30例早期前列腺癌患者根治性前列腺切除术标本中各癌灶的DNA倍体值，以便进一步探究每个独立癌灶的恶性潜能。确定了63个独立癌灶中每个癌灶的体积、分级、侵袭性（包膜外扩展或精囊侵犯）以及起源区域。在同一福尔根染色的组织切片上，将200个癌细胞的DNA倍体直方图与50个正常上皮细胞核进行比较。60%的癌灶为二倍体，40%为非二倍体。倍体与体积和分级相关。所有体积小于0.02 cm³的癌灶均为二倍体；体积在0.02至2.0 cm³之间的病灶中有26%为非二倍体，体积大于2.0 cm³的病灶中有82%为非二倍体。有16个起源于移行带的癌灶，大小从0.02至12.1 cm³不等，只有一个（7.3 cm³）为非二倍体。有47个起源于外周带的癌灶（范围为0.01至18.98），其中24个（51%）为非二倍体。24个非二倍体癌灶中有8个较小（小于1.0 cm³），两个仅为0.03 cm³。我们得出结论，一些非常小的前列腺癌为非二倍体，且前列腺癌的进展并非仅取决于体积，即肿瘤并非仅在体积较大时才获得完全的恶性潜能。起源于外周带的癌灶比起源于移行带的癌灶在更小的体积时就获得了非二倍体细胞群，这进一步支持了这些区域发生的癌症之间存在根本差异。
