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[前列腺癌。第1部分:1966年至2015年细胞动力学回顾及国际泌尿病理学会(ISUP)新分级的未来展望]

[Prostate cancer. Part 1: Review of cell kinetics over the years 1966-2015 and future perspectives of the new grading of the International Society of Urological Pathology (ISUP)].

作者信息

Helpap B, Bubendorf L

机构信息

Institut für Pathologie, Hegau-Bodensee-Kliniken, Akademisches Lehrkrankenhaus, Universität Freiburg, 78207, Postfach 720, Singen, Deutschland.

Abteilung Zytopathologie, Institut für Pathologie, Universität Basel, Basel, Schweiz.

出版信息

Pathologe. 2016 Feb;37(1):3-10. doi: 10.1007/s00292-015-0123-y.

Abstract

Using tritium-labeled thymidine histoautoradiography, the AgNOR staining technique and Ki67-MIB-1 immunohistochemistry to study cell kinetics, prostate cancer can be subdivided into slowly, moderately and rapidly proliferating tumors. These are important supplementary methods and prerequisites for a grading as low, intermediate and high-grade in addition to classical histology and cytology. Cytometry of DNA can confirm the cell kinetics of prostate cancer by detection of a predominance of diploid or aneuploid cell nuclei but should only be evaluated together with histological investigations. All histology-based analyses of cell kinetics encompass the classical highly and poorly differentiated glandular and cribriform patterns as well as solid undifferentiated structures and the various subcategories. The malignancy grading of prostate cancer can result from the summation of histological grading and cell kinetic analyses, as long as the named investigations are included. The future perspectives of individualized therapy options, including active surveillance in early low-grade and also for high-grade prostate cancer and new antihormonal treatment in advanced disease, may increasingly rely on tissue biomarkers and advanced technologies for whole genome analysis including next generation sequencing.

摘要

利用氚标记胸腺嘧啶核苷组织放射自显影术、AgNOR染色技术和Ki67-MIB-1免疫组织化学方法研究细胞动力学,前列腺癌可分为增殖缓慢、中等和快速的肿瘤。除了经典的组织学和细胞学检查外,这些是进行低、中、高分级的重要辅助方法和前提条件。DNA细胞计数法可通过检测二倍体或非整倍体细胞核的优势来确认前列腺癌的细胞动力学,但应仅与组织学研究一起进行评估。所有基于组织学的细胞动力学分析都包括经典的高分化和低分化腺性及筛状模式,以及实性未分化结构和各种亚类。只要纳入上述研究,前列腺癌的恶性分级可由组织学分级和细胞动力学分析的总和得出。个性化治疗方案的未来前景,包括早期低级别前列腺癌以及高级别前列腺癌的主动监测,以及晚期疾病的新型抗激素治疗,可能会越来越依赖组织生物标志物和包括下一代测序在内的全基因组分析先进技术。

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