Schröder F, Tribukait B, Böcking A, DeVere White R, Koss L, Lieber M, Stenkvist B, Zetterberg A
Department of Urology and Nephrology, Erasmus University, Rotterdam, The Netherlands.
Scand J Urol Nephrol Suppl. 1994;162:51-63; discussion 15-27.
At a WHO consensus conference on Early Diagnosis and Prognostic Parameters in Localized Prostate Cancer, a working group discussed the clinical utility of DNA measurements in stages T2 and T3 prostate carcinoma. Incidentally discovered prostate cancer of stage T1 was excluded. The members of the working group, representing various clinical and laboratory disciplines, discussed technical considerations of DNA measurements by flow and image analysis, pretreatment prediction of prognosis, and posttreatment clinical relevance. The group agreed to subdivide tumors into diploid, tetraploid and non-tetraploid aneuploid, expressing various degrees of aggressiveness and gave guidance for the definition of limits of these groups. The panel agreed that knowledge on DNA ploidy prior to treatment is of value in treatment decisions, particularly when surveillance is a treatment option. Aneuploid tumors can be expected to respond very poorly to either irradiation or endocrine therapy, and the presence of aneuploid tumor, either on pretreatment biopsies or in radical prostatectomy specimens, is an ominous sign. The identification of a group of patients with a uniformly poor prognosis should encourage medical oncologists and basic scientists to develop adequate treatment options for this particular group. The panel expressed a strong opinion that DNA ploidy should be uniformly studied in clinical trials, particularly in patients with localized prostate cancer.
在世界卫生组织关于局限性前列腺癌早期诊断和预后参数的共识会议上，一个工作组讨论了DNA检测在T2和T3期前列腺癌中的临床应用。偶然发现的T1期前列腺癌被排除在外。代表不同临床和实验室学科的工作组成员讨论了通过流式细胞术和图像分析进行DNA检测的技术考量、预后的治疗前预测以及治疗后的临床相关性。该小组同意将肿瘤分为二倍体、四倍体和非四倍体非整倍体，它们表现出不同程度的侵袭性，并为这些组别的界限定义提供了指导。专家小组一致认为，治疗前关于DNA倍性的知识在治疗决策中具有价值，尤其是当监测是一种治疗选择时。非整倍体肿瘤预计对放疗或内分泌治疗的反应都非常差，并且在治疗前活检或根治性前列腺切除标本中存在非整倍体肿瘤是一个不祥之兆。识别出一组预后始终很差的患者，应促使肿瘤内科医生和基础科学家为这一特定群体开发适当治疗方案。专家小组强烈认为，在临床试验中，尤其是在局限性前列腺癌患者中，应统一研究DNA倍性。
