Schroeder F H, Blom J H, Hop W C, Mostofi F K
Prostate. 1985;6(1):81-100. doi: 10.1002/pros.2990060109.
This paper contains the first part of an attempt to quantitate the impact on prognosis of various parameters used in grading of prostatic cancer. Out of 346 patients of Elmer Belts series, 113 were identified whose tumors showed homogeneity with respect to single characteristics of a total of 12 parameters applied for grading in Mostofi's system. By this procedure it was possible to eliminate the possible influence on prognosis of the presence of several tumor formations within the same tumor. By using overall and intercurrent death corrected survival as end points, the impact of each of the 12 parameters on prognosis was studied. Only the architecture of the tumor (the parameter "glands"), variation in size and shape of the nucleus (anaplasia), and grade significantly influenced overall survival. In addition, corrected survival was significantly dependent on the amount of tumor seen and on the presence of mitoses. Subsequently, an attempt was made to replace "grade" by single parameters which had been shown previously to be of prognostic significance. It turned out that this was not possible. Grade is largely dependent on architecture and nuclear pleomorphism, but neither one of these parameters alone can reproduce "grade." Multivariate analysis was next used to further determine the prognostic weight of the individual parameter, and, if possible, to construct a new, more efficient grading system. These results will be reported separately [8]. It is unknown at the present time what the impact of several architectural formations within the same tumor on prognosis may be. The number of different formations found ranges from 1 to 4 in this material; 668 different formations belonging to 346 tumors were graded. The results of this analysis will be reported in part two of this series of papers [7].
本文包含了一项尝试的第一部分，该尝试旨在量化前列腺癌分级中使用的各种参数对预后的影响。在埃尔默·贝尔茨系列的346例患者中，确定了113例患者，其肿瘤在应用于莫斯托菲系统分级的总共12个参数的单一特征方面表现出一致性。通过这种方法，可以消除同一肿瘤内存在多个肿瘤形成对预后可能产生的影响。以总体生存和校正并发死亡后的生存作为终点，研究了12个参数中的每一个对预后的影响。只有肿瘤结构（参数“腺体”）、细胞核大小和形状的变化（间变）以及分级对总体生存有显著影响。此外，校正后的生存显著依赖于所见肿瘤的数量和有丝分裂的存在。随后，尝试用先前已证明具有预后意义的单一参数取代“分级”。结果发现这是不可能的。分级在很大程度上依赖于结构和核多形性，但这些参数单独都无法重现“分级”。接下来使用多变量分析进一步确定各个参数的预后权重，并尽可能构建一个新的、更有效的分级系统。这些结果将另行报告[8]。目前尚不清楚同一肿瘤内多个结构形成对预后的影响可能是什么。在该材料中发现的不同结构的数量范围为1至4；对属于346个肿瘤的668个不同结构进行了分级。该分析结果将在本系列论文的第二部分中报告[7]。
