Eskelinen M, Lipponen P, Majapuro R, Syrjänen K
Department of Surgery, University of Kuopio, Finland.
Eur Urol. 1991;19(4):274-8. doi: 10.1159/000473642.
A series of 91 patients with prostatic adenocarcinoma were retrospectively followed up for an average of 15.6 years. The biopsies of the primary tumours were analysed using morphometry for six nuclear features, mitotic-activity index (MAI) and volume-corrected mitotic index. The histological grading of the tumours into three grades was done, and perineural infiltration and lymphatic infiltration were estimated. Clinical stage (p = 0.0137), lymphatic infiltration (p = 0.076) and histological grade (p = 0.1603) were the best predictors of survival in univariate analysis. A multiparameter analysis of progression in T category disclosed the MAI to be the most important single prognostic factor (p = 0.0276). Histological grade predicted progression in M category (p = 0.0166) in the same analysis. In intracapsular T1-T2 tumours, the SD of nuclear perimeter (p = 0.008) was shown by a multivariate analysis to be the most important predictor of progression. Progressed T1-T2 tumours had higher mitotic index values (p = 0.0215). The results advocate the use of mitotic indexes and morphometric measurements instead or as an adjunct of the conventional histological grading while predicting the progression of prostatic adenocarcinoma.
对91例前列腺腺癌患者进行了回顾性随访，平均随访时间为15.6年。采用形态计量学分析原发性肿瘤活检标本的六个核特征、有丝分裂活性指数（MAI）和体积校正有丝分裂指数。对肿瘤进行组织学分级，分为三级，并评估神经周围浸润和淋巴浸润情况。在单因素分析中，临床分期（p = 0.0137）、淋巴浸润（p = 0.076）和组织学分级（p = 0.1603）是生存的最佳预测因素。对T分期进展的多参数分析显示，MAI是最重要的单一预后因素（p = 0.0276）。在同一分析中，组织学分级可预测M分期的进展（p = 0.0166）。在包膜内T1-T2肿瘤中，多因素分析显示核周长标准差（p = 0.008）是进展的最重要预测因素。进展期T1-T2肿瘤的有丝分裂指数值较高（p = 0.0215）。结果表明，在预测前列腺腺癌进展时，可使用有丝分裂指数和形态计量学测量方法替代传统组织学分级或作为其辅助手段。
