Park Junsoo, Jeong In Gab, Bang Jeong Kyoon, Cho Young Mee, Ro Jae Y, Hong Jun Hyuk, Ahn Hanjong, Kim Choung-Soo
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Korean J Urol. 2010 Jun;51(6):386-90. doi: 10.4111/kju.2010.51.6.386. Epub 2010 Jun 21.
To analyze the preoperative clinical and pathological characteristics of patients with pT0 prostate cancer.
We retrospectively reviewed the records of 702 patients who underwent radical prostatectomy (RP) at our institution between January 2004 and July 2008 for clinically localized prostate cancer. If there was no evidence of residual tumor in the pathological specimen of the prostate, a patient was staged as pT0. Patients with pT0 disease were compared with a control group of patients who were operated on during the same period.
Overall, 9 (1.3%) patients were staged as pT0 on the pathologic examination. Significant differences were observed between the pT0 group and the control patients in the biopsy Gleason score (p=0.004), the number of positive cores on biopsy (p=0.018), the tumor length of positive cores (p<0.001), and prostate volume (p=0.015). Cutoff values predictive of pT0 tumor status were defined as a biopsy Gleason score sum </=6, 2 or fewer positive biopsy cores, tumor length on biopsy </=2 mm, and prostate volume >30 cm(3). Whereas 8 of the 9 (88.9%) pT0 patients showed all of these characteristics, only 55 of the 693 (7.9%) control patients fulfilled the criteria. The combination suggested above afforded a sensitivity of 88.8% and a specificity of 92.1% for the prediction of pT0 status.
The frequency of pT0 prostate cancer seen on RP was 1.3%. A combination of clinicopathological features, incorporating a biopsy Gleason score, the number of positive biopsy cores, tumor length on biopsy, and prostate volume, was useful to predict pT0 stage on RP.
分析pT0期前列腺癌患者的术前临床及病理特征。
我们回顾性分析了2004年1月至2008年7月期间在我院因临床局限性前列腺癌接受根治性前列腺切除术（RP）的702例患者的病历。如果前列腺病理标本中没有残留肿瘤的证据，则患者被分期为pT0。将pT0期疾病患者与同期接受手术的对照组患者进行比较。
总体而言，9例（1.3%）患者在病理检查中被分期为pT0。pT0组与对照患者在活检Gleason评分（p=0.004）、活检阳性核心数量（p=0.018）、阳性核心的肿瘤长度（p<0.001）和前列腺体积（p=0.015）方面存在显著差异。预测pT0肿瘤状态的临界值定义为活检Gleason评分总和≤6、活检阳性核心2个或更少、活检肿瘤长度≤2 mm以及前列腺体积>30 cm³。9例pT0患者中有8例（88.9%）表现出所有这些特征，而693例对照患者中只有55例（7.9%）符合标准。上述组合对pT0状态预测的敏感性为88.8%，特异性为92.1%。
RP时所见pT0期前列腺癌的发生率为1.3%。结合活检Gleason评分、活检阳性核心数量、活检肿瘤长度和前列腺体积的临床病理特征组合，有助于预测RP时的pT0分期。
