Iczkowski Kenneth A, Torkko Kathleen C, Kotnis Gregory R, Wilson R Storey, Huang Wei, Wheeler Thomas M, Abeyta Andrea M, Lucia M Scott
Department of Pathology, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA.
Prostate Cancer. 2011;2011:693853. doi: 10.1155/2011/693853. Epub 2011 Jul 14.
We demonstrated in 2011 that 61% of men with postoperative PSA failure had some cribriform pattern of prostate cancer, versus 16% of nonfailures (OR = 5.89, P < .0001). That study used digitized radical prostatectomy slides from 153 men, 76 failures (≥0.2 ng/mL) matched to 77 nonfailures. The current study's hypothesis: pseudolumen size and shape variability could stratify outcome within histologic patterns (single separate acini, separate acini with undulating lumens, fused small acini, papillary, cribriform). Pseudolumens were filled digitally on image captures from previously annotated specimens. Among all 5 patterns, pseudolumen spaces averaged smaller in failures than nonfailures. After multivariate analysis controlling for stage, age, margin, cancer amount, prostate volume, and presence of individual cells (grade 5), this retained significance only for the undulating-lumens and papillary patterns. In undulating-lumens pattern, PSA failures had smaller mean pseudolumen space sizes (P = .03) but larger perimeters (P = .04), implying more pseudolumen irregularity. In papillary pattern, the number of pseudolumen spaces was higher in failures (P = .015), space size was smaller (P = .11), perimeters were smaller (P = .04), and perimeter/size ratio was higher (P = .02). In conclusion, digitally measured pseudolumen size and shape may associate with outcome.
2011年我们证实，术后前列腺特异性抗原（PSA）失败的男性中，61%患有某种筛状型前列腺癌，而未出现PSA失败的男性中这一比例为16%（比值比=5.89，P<.0001）。该研究使用了153名男性的数字化根治性前列腺切除术切片，76例PSA失败患者（PSA≥0.2 ng/mL）与77例未失败患者进行匹配。本研究的假设：假管腔大小和形状变异性可在组织学模式（单个分离腺泡、具有波浪状管腔的分离腺泡、融合小腺泡、乳头状、筛状）内对预后进行分层。通过对先前标注标本的图像采集进行数字填充来形成假管腔。在所有5种模式中，PSA失败患者的假管腔空间平均比未失败患者小。在对分期、年龄、切缘、癌灶大小、前列腺体积和单个细胞（5级）的存在情况进行多因素分析后，只有波浪状管腔和乳头状模式仍具有统计学意义。在波浪状管腔模式中，PSA失败患者的平均假管腔空间尺寸较小（P=.03），但周长较大（P=.04），这意味着假管腔更不规则。在乳头状模式中，PSA失败患者的假管腔数量较多（P=.015），空间尺寸较小（P=.11），周长较小（P=.04），周长/尺寸比更高（P=.02）。总之，数字测量的假管腔大小和形状可能与预后相关。
