Brawn P N
Cancer. 1983 Jul 15;52(2):246-51. doi: 10.1002/1097-0142(19830715)52:2<246::aid-cncr2820520210>3.0.co;2-q.
Fifty-four patients with prostate carcinoma, each having 2 TURP (transurethral resection of the prostate) procedures separated by 3 to 11 years, were studied to determine whether the histologic appearance of prostate carcinoma remains the same for the life of the host or whether the histological appearance changes with time. Using the M. D. Anderson (MDAH) method of grading prostate carcinoma, 19 of 26 (73%) Grade 1 lesions, 9 of 12 (75%) Grade 2 lesions, and 7 of 8 (88%) Grade 3 lesions dedifferentiated into another grade at the time of the 2nd TURP. Eight cases that were Grade 4 at the time of the 1st TURP, remained Grade 4 lesions at the time of the 2nd TURP. Although 10 Grade 1, Grade 2, and Grade 3 lesions did not change grades, 8 of these 10 cases were less differentiated at the time of the second TURP than they were at the time of the first TURP. Furthermore, no Grade 1 lesions demonstrated evidence of metastases, but 19% of Grade 2 lesions, 55% of Grade 3 lesions, and 80% of Grade 4 lesions demonstrated evidence of metastases. This study suggests that the usual course of prostate carcinoma is dedifferentiation and that with dedifferentiation, the likelihood of metastases increases.
对54例前列腺癌患者进行了研究，这些患者均接受过2次经尿道前列腺切除术（TURP），两次手术间隔3至11年，目的是确定前列腺癌的组织学表现对于宿主一生来说是否保持不变，或者组织学表现是否会随时间变化。采用MD安德森（MDAH）前列腺癌分级方法，26例1级病变中有19例（73%）、12例2级病变中有9例（75%）、8例3级病变中有7例（88%）在第二次TURP时出现去分化，转变为另一级别。1例在第一次TURP时为4级的病变，在第二次TURP时仍为4级病变。虽然10例1级、2级和3级病变级别未改变，但这10例中的8例在第二次TURP时比第一次TURP时分化程度更低。此外，1级病变均未显示转移迹象，但2级病变中有19%、3级病变中有55%、4级病变中有80%显示有转移迹象。这项研究表明，前列腺癌的通常病程是去分化，并且随着去分化，转移的可能性增加。
