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前列腺穿刺活检标本中的前列腺导管内癌:与根治性前列腺切除术后侵袭性病理特征的相关性及在高危前列腺癌中的预后价值。

Intraductal carcinoma of the prostate in prostate biopsy samples: correlation with aggressive pathological features after radical prostatectomy and prognostic value in high-risk prostate cancer.

机构信息

Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Asian J Androl. 2020 Sep-Oct;22(5):519-525. doi: 10.4103/aja.aja_117_19.

Abstract

Intraductal carcinoma of the prostate (IDC-P) is an aggressive pathological pattern of prostate cancer (PCa). We investigated the association of IDC-P in prostate biopsy (PBx) with several pathological features after radical prostatectomy (RP) and its prognostic value in high-risk PCa. A total of 418 patients with high-risk PCa after RP were included in this study. IDC-P and its architectural patterns were identified according to the 2016 World Health Organization Classification. Chi-squared test and logistic regression were used to investigate the correlation between IDC-P and post-RP pathological features. Kaplan-Meier curves and Cox regression were applied to explore the prognostic value of IDC-P. IDC-P was identified in PBx in 36/418 (8.6%) patients. Logistic regression indicated that IDC-P in PBx was independently associated with several pathological features of RP, including Gleason score 8-10 (P < 0.001), seminal vesicular invasion (P < 0.001), and pathological T (pT) 3a (P = 0.043). Patients with IDC-P in PBx manifested poorer biochemical-free survival (BFS) than those without IDC-P (37.47 months vs not reached, P < 0.001). The addition of IDC-P in several prognostic nomograms could improve the predictive accuracy of these tools. We conclude that IDC-P in PBx is positively associated with several aggressive pathological features after RP in high-risk PCa. In addition, IDC-P in PBx could effectively predict the BFS of high-risk PCa patients after RP.

摘要

前列腺导管内癌(IDC-P)是一种侵袭性的前列腺癌(PCa)病理模式。我们研究了前列腺根治性切除术(RP)后 IDC-P 与几种病理特征的相关性及其在高危 PCa 中的预后价值。本研究共纳入 418 例 RP 后高危 PCa 患者。根据 2016 年世界卫生组织分类,确定 IDC-P 及其结构模式。卡方检验和逻辑回归用于研究 IDC-P 与 RP 后病理特征的相关性。Kaplan-Meier 曲线和 Cox 回归用于探讨 IDC-P 的预后价值。在 418 例患者中,36 例(8.6%)在 PBx 中发现 IDC-P。逻辑回归表明,PBx 中的 IDC-P 与 RP 的几种病理特征独立相关,包括 Gleason 评分 8-10(P < 0.001)、精囊侵犯(P < 0.001)和病理 T(pT)3a(P = 0.043)。PBx 中有 IDC-P 的患者生化无复发生存(BFS)较无 IDC-P 的患者差(37.47 个月 vs 未达到,P < 0.001)。在几个预后列线图中加入 IDC-P 可以提高这些工具的预测准确性。我们得出结论,PBx 中的 IDC-P 与高危 PCa 患者 RP 后几种侵袭性病理特征呈正相关。此外,PBx 中的 IDC-P 可有效预测高危 PCa 患者 RP 后的 BFS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5566/7523608/9ef6f13ecefc/AJA-22-519-g001.jpg

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