Montie J E
Section of Urology, University of Michigan School of Medicine, Ann Arbor, USA.
Cancer. 1996 Jul 15;78(2):341-4. doi: 10.1002/(SICI)1097-0142(19960715)78:2<341::AID-CNCR24>3.0.CO;2-V.
Prostate carcinoma provides a wide spectrum for risk of death from the disease and clinicians have long sought methods to predict the outcome accurately in individual patients. Traditional prognostic factors, such as histologic grade and stage, remain valuable. Additional clinical and laboratory studies may add to the precision of predicting the natural history of the disease or response to therapy.
A review of the literature on current, well accepted prognostic factors for prostate carcinoma and evolving methodology for the incorporation of new factors was conducted.
The most widely used current prognostic factors for survival of patients with prostate carcinoma include clinical and pathologic stage, histologic grade, prostate specific antigen (PSA) level, age, and comorbidity. DNA ploidy has been extensively studied on radical prostatectomy specimens and appears valuable, but is not widely employed. The utility of DNA ploidy on biopsy specimens is less certain because of both methodologic issues and heterogeneity within the tumor. The statistical tools used to identify and validate new prognostic factors are critical and new techniques are sought to incorporate several independent factors into a prognostic score or index for an individual patient.
Current prognostic factors for prostate carcinoma provide important information for patient care and research. However, new methods to define pretreatment prognosis and needed to assist clinicians and patients in making therapeutic choices for prostate carcinoma. The ideal method with which to incorporate the information attained from anatomic stage, histologic grade, PSA level, age, and comorbidity into a manageable prognostic score is uncertain and studies on this topic should be a high priority research objective.
前列腺癌患者的疾病死亡风险范围广泛，长期以来临床医生一直在寻找能准确预测个体患者预后的方法。传统的预后因素，如组织学分级和分期，仍然很有价值。其他临床和实验室研究可能会提高预测疾病自然史或治疗反应的准确性。
对当前关于前列腺癌公认的预后因素及纳入新因素的不断发展的方法的文献进行综述。
目前最广泛用于预测前列腺癌患者生存的预后因素包括临床和病理分期、组织学分级、前列腺特异性抗原（PSA）水平、年龄和合并症。DNA倍体已在根治性前列腺切除术标本上进行了广泛研究，似乎很有价值，但尚未广泛应用。由于方法学问题和肿瘤内的异质性，DNA倍体在活检标本中的实用性尚不确定。用于识别和验证新预后因素的统计工具至关重要，并且正在寻求新技术将多个独立因素纳入个体患者的预后评分或指数中。
目前前列腺癌的预后因素为患者护理和研究提供了重要信息。然而，需要新的方法来确定治疗前的预后，以帮助临床医生和患者做出前列腺癌的治疗选择。将从解剖学分期、组织学分级、PSA水平、年龄和合并症中获得的信息整合到一个可管理的预后评分中的理想方法尚不确定，关于这一主题的研究应成为高度优先的研究目标。
