McNeal J E, Yemoto C E
Department of Urology, Stanford University Hospital, CA 94306, USA.
Am J Surg Pathol. 1996 Nov;20(11):1351-60. doi: 10.1097/00000478-199611000-00006.
Histologically demonstrable vascular invasion by tumor has been reported as an index of poor prognosis correlating with increased probability of metastasis in many types of cancer other than prostatic. We quantitated vascular invasion foci in 357 radical prostatectomy specimens and developed improved criteria for their diagnosis and their distinction from fixation artifact. Vascular invasion foci were found in 7% of cancers less than 4 cc in volume and 24% of larger cancers. Most foci were selectively located either near the basal end of the cancer or near the transition zone border. Correlations among multiple morphologic variables showed significant correlation of vascular invasion only with the presence of intraductal carcinoma. The only statistically significant independent predictors of disease progression (serum prostate-specific antigen elevation) were vascular invasion, carcinoma grade, and cancer volume. Our findings suggest that further study of vascular invasion foci may disclose additional information about the biologic features of local and distant spread of prostatic carcinoma.
组织学上可证实的肿瘤血管侵犯已被报道为预后不良的指标，在除前列腺癌之外的许多类型癌症中，它与转移概率增加相关。我们对357例前列腺癌根治术标本中的血管侵犯灶进行了定量分析，并制定了改进的诊断标准以及将其与固定伪像区分开来的标准。在体积小于4立方厘米的癌症中，7%发现有血管侵犯灶，而在体积较大的癌症中这一比例为24%。大多数病灶选择性地位于癌的基底端附近或移行带边界附近。多个形态学变量之间的相关性显示，血管侵犯仅与导管内癌的存在显著相关。疾病进展（血清前列腺特异性抗原升高）的唯一具有统计学意义的独立预测因素是血管侵犯、癌分级和癌体积。我们的研究结果表明，对血管侵犯灶的进一步研究可能会揭示有关前列腺癌局部和远处扩散生物学特征的更多信息。
