Department of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Witten/Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany.
Department of Urology, Helios University Hospital Wuppertal, Witten/Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany.
BMC Urol. 2023 Jan 6;23(1):6. doi: 10.1186/s12894-022-01167-5.
To evaluate the incidence of lymph node degeneration and its association with nodal metastatic pattern in prostate cancer.
A retrospective analysis of the submitted lymph node specimen of 390 prostatectomies in 2011 was performed. All lymph nodes were histologically re-evaluated and the degree of lymph node degeneration e.g. lipomatous atrophy, capsular and framework fibrosis, and calcifications as well as the lymph node size were recorded. Lymph node degeneration was compared in the anatomic regions of the pelvis as well as in lymph nodes with and without metastases of prostatic cancer.
Eighty-one of 6026 lymph nodes demonstrated metastases. Complete histologic examination with analysis of a complete cross-section was possible in 5173 lymph nodes including all lymph nodes with metastases. The incidence of lymph node degeneration was different across the various landing sites. Lymph node metastases were primarily detected in less degenerative and therefore more functional lymph nodes. In metastatic versus non-metastatic lymph nodes low lipomatous atrophy was reported in 84.0% versus 66.7% (p = 0.004), capsular fibrosis in 14.8% versus 35.4% (p < 0.001), calcifications in 35.8% versus 46.1% (p = 0.072) and framework fibrosis in 69.8% versus 75.3% (p = 0.53). Metastases were also identified more frequently in larger than in smaller lymph nodes (63.0% vs. 47.5%; p = 0.007).
Degenerative changes in pelvic lymph nodes are commonly detectable but occur with variable frequency in the various nodal landing sites in the pelvis. The degree of lymph node degeneration of single lymph nodes has a significant influence on whether a lymph node is infiltrated by tumor cells and may harbour metastases.
评估淋巴结变性的发生率及其与前列腺癌淋巴结转移模式的关系。
对 2011 年 390 例前列腺切除术的送检淋巴结标本进行回顾性分析。所有淋巴结均进行组织学重新评估，并记录淋巴结变性程度，如脂肪萎缩、包膜和支架纤维化以及钙化，以及淋巴结大小。比较了骨盆解剖区域以及有和无前列腺癌转移的淋巴结中的淋巴结变性情况。
6026 个淋巴结中有 81 个有转移。对包括所有有转移的淋巴结在内的 5173 个淋巴结进行了完整的组织学检查和完整的横断面分析。不同着陆点的淋巴结变性发生率不同。淋巴结转移主要发生在变性程度较低、功能更正常的淋巴结中。在转移性与非转移性淋巴结中，低脂肪萎缩分别为 84.0%与 66.7%（p=0.004），包膜纤维化分别为 14.8%与 35.4%（p<0.001），钙化分别为 35.8%与 46.1%（p=0.072），支架纤维化分别为 69.8%与 75.3%（p=0.53）。在较大的淋巴结中也更常发现转移（63.0% vs. 47.5%；p=0.007）。
盆腔淋巴结的退行性变化通常是可检测到的，但在骨盆的不同淋巴结着陆点发生的频率不同。单个淋巴结的淋巴结变性程度对淋巴结是否被肿瘤细胞浸润并可能存在转移有显著影响。
