Wang X, Brannigan R E, Rademaker A W, McVary K T, Oyasu R
Department of Pathology, Northwestern University Medical School and Northwestern University Cancer Center Biometry Section, Chicago, Illinois, USA.
J Urol. 1997 Oct;158(4):1431-5.
In view of the recent increase in patients presenting with only 1 core positive for prostate carcinoma, we examined the correlation in tumor volume between the biopsy and the subsequent radical prostatectomy specimen.
We studied a total of 169 consecutive prostate biopsies with matched radical prostatectomy specimens and selected 48 patients with only 1 positive core.
Cancers found in the biopsy regardless of their size were associated with a wide range of cancer volume in the radical prostatectomy specimens, and the amount of cancer in the biopsy was a poor predictor of the volume of cancer in the prostatectomy specimen. Even with a cancer of 3 mm. or less in the biopsy, 57% of patients had cancer of clinically significant volume (greater than 0.5 ml.). Other modalities for the evaluation of prostate cancer such as Gleason score and clinical stage were not helpful in segregating patients with clinically significant from those with insignificant volume of cancer. However, when combined with a preoperative serum prostate-specific antigen higher than 10 ng./ml., 1 core positive biopsy could reliably predict the presence of cancer of significant volume.
One core only positive prostate biopsy, when accompanied by an elevated serum prostate specific antigen value (greater than 10 ng./ml.), strongly suggests the presence of clinically significant cancer.
鉴于近期仅1个活检核心为前列腺癌阳性的患者数量增加，我们研究了活检标本与随后的根治性前列腺切除术标本中肿瘤体积的相关性。
我们共研究了169例连续的前列腺活检病例及其匹配的根治性前列腺切除术标本，并选取了48例仅1个活检核心为阳性的患者。
活检中发现的癌症，无论其大小如何，在根治性前列腺切除术标本中都与广泛的癌体积相关，活检中的癌量并不能很好地预测前列腺切除术标本中的癌体积。即使活检中癌灶为3毫米或更小，57%的患者仍有临床显著体积（大于0.5毫升）的癌症。其他评估前列腺癌的方式，如Gleason评分和临床分期，对于区分临床显著癌体积患者和非显著癌体积患者并无帮助。然而，当与术前血清前列腺特异性抗原高于10纳克/毫升相结合时，1个活检核心阳性可可靠地预测存在显著体积的癌症。
仅1个活检核心为阳性的前列腺活检，若伴有血清前列腺特异性抗原值升高（大于10纳克/毫升），强烈提示存在临床显著的癌症。
