Elamin Saif, Bhatt Nikita Rajiv, Davis Niall F, Sweeney Paul
Registrar, Department of Urology, Mercy University Hospital , Cork, Ireland .
SHO, Department of Urology, University Hospital Limerick, Ireland .
J Clin Diagn Res. 2016 Apr;10(4):PC01-3. doi: 10.7860/JCDR/2016/16401.7589. Epub 2016 Apr 1.
Considerable Proportion of Prostate Cancer (PCa) patients suitable for Active Surveillance (AS) harbour aggressive disease at surgical histopathology. Identification of truly indolent prostate cancer at diagnosis is difficult.
Of this study was to evaluate the accuracy of current AS protocols in identifying low risk PCa by comparing the histopathology at biopsy and surgery.
A retrospective study was performed on all patients who underwent Radical Prostatectomy (RP) between 2008 and 2012. We identified patients who fulfilled inclusion criteria of five different established AS protocols. Histopathology at biopsy was compared with final surgical histopathology to identify upgrading or upstaging of disease. The biochemical recurrence rate in the cohort was also determined.
A total of 59 patients (24%) met criteria of at least one protocol. Sixteen patients (28%) were eligible for AS based on all studied criteria. Overall 24 patients (40.6%) were upgraded in their final histopathology while 12 patients (20%) upstaged from their original TRUS biopsy. Two patients (3%) had PSA failure, both had salvage radiotherapy.
There is considerable discrepency in current AS selection criteria which makes it necessary to introduce novel markers to identify indolent disease as a part of AS protocol for PCa.
相当一部分适合主动监测（AS）的前列腺癌（PCa）患者在手术组织病理学检查时存在侵袭性疾病。在诊断时识别真正惰性的前列腺癌很困难。
本研究旨在通过比较活检和手术时的组织病理学，评估当前AS方案在识别低风险PCa方面的准确性。
对2008年至2012年间所有接受根治性前列腺切除术（RP）的患者进行回顾性研究。我们确定了符合五种不同既定AS方案纳入标准的患者。将活检时的组织病理学与最终手术组织病理学进行比较，以确定疾病的升级或分期上调。还确定了该队列中的生化复发率。
共有59名患者（24%）符合至少一种方案的标准。根据所有研究标准，16名患者（28%）符合AS条件。总体而言，24名患者（40.6%）在最终组织病理学检查中病情升级，而12名患者（20%）从最初的经直肠超声（TRUS）活检分期上调。两名患者（3%）出现前列腺特异性抗原（PSA）失败，均接受了挽救性放疗。
当前AS选择标准存在相当大的差异，这使得有必要引入新的标志物来识别惰性疾病，作为PCa的AS方案的一部分。
