Goto Y, Ohori M, Arakawa A, Kattan M W, Wheeler T M, Scardino P T
Matsunaga-Conte Prostate Cancer Research Center, Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
J Urol. 1996 Sep;156(3):1059-63.
We assessed the ability of diagnostic tests to distinguish clinically unimportant cancers.
We correlated T stage (based on digital examination and ultrasound), prostate specific antigen (PSA), PSA density and pathological features of cancer in systematic biopsy specimens with features of cancer in 170 radical prostatectomy specimens. Clinically unimportant cancers were defined as small (0.5 cm.3 or less), well or moderately differentiated and confined to the prostate.
Of the patients 10% had an unimportant cancer. On logistic regression analysis the 2 significant predictors were maximum length of cancer in any core and PSA density. Of 12 patients with maximum cancer length 2 mm. or less and PSA density less than 0.1., 75% had an unimportant cancer compared to 5% of the remaining 158 (p < 0.0005).
Quantitative analysis of systematic biopsy specimens combined with PSA density provides valuable staging information and helps to identify cancers of low biological potential.
我们评估了诊断测试区分临床意义不大的癌症的能力。
我们将系统活检标本中癌症的T分期（基于指诊和超声）、前列腺特异性抗原（PSA）、PSA密度及病理特征与170例根治性前列腺切除术标本中的癌症特征进行了关联分析。临床意义不大的癌症定义为体积小（0.5立方厘米或更小）、高分化或中分化且局限于前列腺内的癌症。
10%的患者患有临床意义不大的癌症。逻辑回归分析显示，两个显著的预测因素为任何一个活检组织条中癌症的最大长度和PSA密度。在癌症最大长度为2毫米或更小且PSA密度小于0.1的12例患者中，75%患有临床意义不大的癌症，而其余158例患者中这一比例为5%（p<0.0005）。
对系统活检标本进行定量分析并结合PSA密度可提供有价值的分期信息，有助于识别低生物学潜能的癌症。
