Uchida T, Go M, Egawa S, Ao T, Kuwao S, Yokoyama E, Mashimo S, Endo T, Koshiba K
Department of Urology, Kitasato University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1993 Jul;84(7):1293-300. doi: 10.5980/jpnjurol1989.84.1293.
Incidentally discovered prostatic cancer can pursue a benign clinical course or it can rapidly progress. For the purpose of this study, we summarized pathological and clinical results of 107 (5.3%) stage A prostatic cancer patients in 2008 transurethral resection of the prostate for clinically diagnosed benign prostatic hyperplasia. For each patient, 3.9 slides, 13.6 tissue chips per slide and 52.5 tissue chips per patient (from 16 to 140 chips) were examined microscopically. The survival rates of patient with well, moderately and poorly differentiated groups were 62, 37 and 12% at 10 years, and those with Gleason score 2 to 4, 5 to 7 and 8 to 10 group were 63, 42 and 0% respectively. The survival rates in stage A1 (well differentiated or Gleason score 4 or less in less than 5% of the tissue removed during transurethral resection of the prostate) and stage A2 (anything other than stage A1) were 63 and 41% at 10 years, respectively. And cancer specific survival rates in stage A1 and stage A2 were 96% and 64% at 10 years, respectively. The number of cancer specific death were 1 in 30 (3.3%) in stage A1 group and 14 in 77 (18.2%) in stage A2 group. Our results indicated that tumors with low potential for aggressive behavior had a volume extent of less than 5% and a well differentiated group. Aggressive treatments should be recommended to all patients who were diagnosed stage A2 prostatic cancer.
偶然发现的前列腺癌可能呈现良性临床病程，也可能迅速进展。为了本研究的目的，我们总结了2008年因临床诊断为良性前列腺增生而行经尿道前列腺切除术的107例（5.3%）A期前列腺癌患者的病理和临床结果。对每位患者，显微镜检查了3.9张切片、每张切片13.6个组织芯片以及每位患者52.5个组织芯片（从16个至140个芯片）。高分化、中分化和低分化组患者的10年生存率分别为62%、37%和12%，Gleason评分2至4分、5至7分和8至10分组的患者10年生存率分别为63%、42%和0%。A1期（高分化或经尿道前列腺切除术中切除组织中小于5%的Gleason评分4分或更低）和A2期（除A1期以外的任何情况）患者的10年生存率分别为63%和41%。A1期和A2期的癌症特异性生存率10年时分别为96%和64%。A1期组30例中有1例（3.3%）癌症特异性死亡，A2期组77例中有14例（18.2%）癌症特异性死亡。我们的结果表明，具有低侵袭性行为潜能的肿瘤体积范围小于5%且为高分化组。对于所有诊断为A2期前列腺癌的患者应推荐积极治疗。
