Bessede Thomas, Girodon Emmanuelle, Allory Yves, Le Floch Annick, Leroy Karen, Salomon Laurent
Department of Urology, Paris Sud University Hospital of Bicetre, 94270, Le Kremlin Bicetre, France,
World J Urol. 2014 Aug;32(4):899-904. doi: 10.1007/s00345-014-1278-5. Epub 2014 Mar 27.
The aim was to eliminate, by DNA comparison, any identity mismatch between operative and biopsy specimens and to analyse the determinants of all pT0 prostate cancers occurred in a single institution.
All prostate pT0 cases in a single institution over 20 years were investigated. None of the patients had been diagnosed after a transurethral resection of the prostate nor had they received neoadjuvant hormonal treatment. The biopsies performed in other centres had been referred for a centralized pathologic re-analysis. DNA analysis was performed in samples from operative and biopsy specimens, and pairs of tissues were blindly constituted. Correct matching was verified in each pair and compared to the original database in order to comment on the occurrence of identity mismatches in the series.
Nineteen patients (0.77 %) had been diagnosed as having pT0 prostate cancer among the 2,462 RP procedures performed over 19 years. The biopsy re-analysis invalidated the initial diagnosis of prostate cancer in one biopsy set performed elsewhere. Among 12 entirely processed cases, the biochemistry procedure evaluated as "very unlikely" the occurrence of an error in tissue identification in the biopsy setting, during the surgical procedure or the pathological analysis. No identification error of tissue samples was established in this first verified pT0 series.
Although it must be suspected, specimen identification error was not a cause for pT0 prostate cancer. Only after a full pathological and DNA verification, the pT0 stage remains a sole entity, unexplained in most cases.
通过DNA比对消除手术标本与活检标本之间的任何身份不匹配，并分析在单一机构中发生的所有pT0前列腺癌的决定因素。
对单一机构20多年来的所有前列腺pT0病例进行调查。所有患者均未在经尿道前列腺切除术后被诊断，也未接受新辅助激素治疗。其他中心进行的活检已被转诊进行集中病理重新分析。对手术标本和活检标本的样本进行DNA分析，并盲目组成组织对。核实每对组织的正确匹配情况，并与原始数据库进行比较，以评论该系列中身份不匹配的发生情况。
在19年期间进行的2462例根治性前列腺切除术（RP）中，有19例患者（0.77%）被诊断为pT0前列腺癌。活检重新分析使在其他地方进行的一组活检中前列腺癌的初步诊断无效。在12例完全处理的病例中，生化程序评估在活检、手术过程或病理分析中组织识别错误的发生“极不可能”。在这个首次验证的pT0系列中未发现组织样本的识别错误。
尽管必须怀疑，但标本识别错误不是pT0前列腺癌的原因。只有经过全面的病理和DNA验证后，pT0期在大多数情况下仍是一个无法解释的唯一实体。
