Ravery V, Limot O, Tobolski F, Boccon-Gibod L A, Toublanc M, Hermieu J F, Delmas V, Boccon-Gibod L
Department of Urology, CHU Bichat-Claude Bernard, Paris, France.
Eur Urol. 1996;29(3):257-65. doi: 10.1159/000473757.
We review the advances in pathology, biology, and radiology which could improve the detection of extracapsular prostate cancer preoperatively.
The experiences of others are compared to ours to give a topical overview of advances in the assessment of clinically localized prostate cancer.
Despite new technologies, such as colour Doppler and endorectal magnetic resonance imaging, radiology does not enhance the ability to detect small invasion through the prostatic capsule. Biopsy features are one of the new fields of investigation. The number of positive sextant biopsies and the analysis of periprostatic spaces on biopsies appear to be major prognosis factors. In our experience, capsular perforation on biopsy is very powerful with respect to the proportion of positive biopsies ( > 66.7%) and serum PSA ( > 25 ng/ml, polyclonal assay) to predict biological progression after radical prostatectomy. The utility of the proportion of invaded tissue on biopsy is still debated.
Despite technical improvements, the staging of clinically confined prostate cancer is still a major issue. The best hope comes from the study of biopsy features in addition to PSA.
我们回顾病理学、生物学和放射学方面的进展，这些进展可能会改善术前前列腺癌包膜外侵犯的检测。
将他人的经验与我们的经验进行比较，以对临床局限性前列腺癌评估的进展进行专题综述。
尽管有新技术，如彩色多普勒和直肠内磁共振成像，但放射学并不能提高检测前列腺包膜微小侵犯的能力。活检特征是新的研究领域之一。阳性六分区活检的数量以及活检时前列腺周围间隙的分析似乎是主要的预后因素。根据我们的经验，活检时包膜穿孔对于预测根治性前列腺切除术后的生物学进展，在阳性活检比例（>66.7%）和血清前列腺特异抗原（>25 ng/ml，多克隆检测）方面非常有参考价值。活检时受侵组织比例的效用仍存在争议。
尽管技术有所改进，但临床局限性前列腺癌的分期仍然是一个主要问题。最大的希望来自于除前列腺特异抗原外对活检特征的研究。
