Henke R P, Krüger E, Ayhan N, Hübner D, Hammerer P
Department of Pathology, University of Hamburg, Germany.
Hum Pathol. 1994 May;25(5):476-84. doi: 10.1016/0046-8177(94)90119-8.
Prostatic cancer frequently shows striking morphological heterogeneity and multifocal growth. To better understand the relationship between chromosomal changes and pathological characteristics, 31 routinely processed radical prostatectomy specimens were studied for the presence of numerical chromosomal aberrations by in situ hybridization with centromeric nucleic acid probes specific for chromosomes 7, 10, 17, X, and Y. In 24 of the cases preoperative core biopsy specimens were available and were examined with the probe for the X chromosome. In eight of the prostatectomy specimens chromosome numbers consistent with a normal male karyotype were found. Three cases, besides diploid chromosome numbers, showed a focal doubling of hybridization signals, consistent with tetraploidy. The other 20 cases displayed numerical chromosomal aberrations to a various degree. In this group the appearance of numerical chromosomal aberrations often showed considerable local heterogeneity, generally coinciding with morphological dedifferentiation, and was significantly correlated with tumor stage (P = .0004) as well as primary (P = .0068), worst (P = .0002), and combined (P < .0001) Gleason grades, total tumor volume (P = .0448), and the volume of tumor with Gleason grades 4 or 5 (P < .0001). In four of the 24 core biopsy specimens no residual tumor tissue was left for cytogenetic examination. In the remaining 20 biopsy specimens the presence or absence of numerical changes matched the result obtained on the corresponding prostatectomy specimen. We conclude that in prostatic cancer the presence of numerical chromosomal aberrations is associated with advanced disease. Especially in low differentiated tumors local heterogeneity in 2 chromosome numbers can be very marked. It is possible to forecast the presence or absence of numerical chromosomal changes on preoperative core biopsy specimens.
前列腺癌常常表现出显著的形态学异质性和多灶性生长。为了更好地理解染色体变化与病理特征之间的关系,我们通过使用针对染色体7、10、17、X和Y的着丝粒核酸探针进行原位杂交,研究了31例常规处理的根治性前列腺切除术标本中染色体数目异常的情况。在24例病例中,有术前穿刺活检标本,并使用X染色体探针进行了检查。在8例前列腺切除标本中,发现染色体数目与正常男性核型一致。3例除了二倍体染色体数目外,还显示杂交信号局灶性加倍,符合四倍体。其他20例显示出不同程度的染色体数目异常。在这组病例中,染色体数目异常的出现常常表现出相当大的局部异质性,通常与形态学去分化一致,并且与肿瘤分期(P = .0004)、原发(P = .0068)、最差(P = .0002)和综合(P < .0001)Gleason分级、肿瘤总体积(P = .0448)以及Gleason分级为4或5的肿瘤体积(P < .0001)显著相关。在24例穿刺活检标本中的4例中,没有残留肿瘤组织用于细胞遗传学检查。在其余20例活检标本中,染色体数目变化的有无与相应前列腺切除标本的结果相符。我们得出结论,在前列腺癌中,染色体数目异常的存在与疾病进展相关。特别是在低分化肿瘤中,染色体数目局部异质性可能非常明显。在术前穿刺活检标本上可以预测染色体数目变化的有无。