Silvestri F, Bussani R, Pavletic N, Bassan F
Institute of Pathological Anatomy, University of Trieste, Italy.
Pathol Res Pract. 1995 Sep;191(9):908-16. doi: 10.1016/S0344-0338(11)80976-3.
Early detection and management of prostatic cancer (PC) is an important public health problem in all industrialized countries, where the relative rate of the elderly population is rapidly increasing. We examined the epidemiology of PC in the province of Trieste, Italy and studied the relationship between prostatic intraepithelial neoplasia (PIN) and PC. The average annual incidence of PC was 99.3 per 100,000 (1,739 new prostatic cancer cases were histologically diagnosed at autopsy or in surgical specimens between 1980 and 1993). In patients over 85 years of age, the incidence rate was 1,209 per 100,000 compared with 64 per 100,000 in the 55-64 age group. Trends in PC incidence rates showed a significant increase among men under 64 years of age and those between 65-74 years. Survival analysis showed that 94% of the patients with well differentiated PC were alive at 5 years, compared with 80% and 40% of those with moderately differentiated and poorly differentiated cancer, respectively. We studied 130 whole autopsy prostates, 70 radical prostatectomies with carcinoma, 63 transurethral resections or adenomectomies without cancer from patients who later developed PC and 94 transurethral resections or adenomectomies from patients who did not develop PC. The 102 prostatic cases with cancer had a high rate of PIN, and the relative frequency of PIN 3 was high (almost 70%, versus almost 0% in benign prostates). In addition, the frequency of PIN was higher in benign prostates of patients who later developed PC (almost 50% of the cases) than in benign autopsy and surgical prostates. PIN was spatially associated with cancer in 75% of the cases. This study confirms the strong relationship between PIN and PC.
在所有工业化国家，前列腺癌（PC）的早期检测与管理都是一个重要的公共卫生问题，这些国家老年人口的相对比例正在迅速上升。我们研究了意大利的里雅斯特省前列腺癌的流行病学情况，并探讨了前列腺上皮内瘤变（PIN）与前列腺癌之间的关系。前列腺癌的年平均发病率为每10万人99.3例（1980年至1993年间，有1739例新的前列腺癌病例经组织学诊断，这些病例来自尸检或手术标本）。在85岁以上的患者中，发病率为每10万人1209例，而在55 - 64岁年龄组中，发病率为每10万人64例。前列腺癌发病率趋势显示，64岁以下男性以及65 - 74岁男性的发病率显著上升。生存分析表明，高分化前列腺癌患者5年生存率为94%，而中分化和低分化癌患者的5年生存率分别为80%和40%。我们研究了130个完整的尸检前列腺标本、70例患有癌症的根治性前列腺切除术标本、63例来自后来发生前列腺癌患者的无癌经尿道切除术或腺瘤切除术标本，以及94例来自未发生前列腺癌患者的经尿道切除术或腺瘤切除术标本。102例患有癌症的前列腺病例中PIN发生率较高，PIN 3的相对频率较高（几乎为70%，而良性前列腺中几乎为0%）。此外，后来发生前列腺癌患者的良性前列腺中PIN的频率（几乎50%的病例）高于良性尸检和手术前列腺。在75%的病例中，PIN在空间上与癌症相关。这项研究证实了PIN与前列腺癌之间的密切关系。
