Modern Pathology:根治性前列腺切除术中的筛状结构能够预测肿瘤结果

2020-08-09 AlexYang MedSci原创

前列腺癌患者中,格林森评分是临床结果的一个重要参数。格林森评分8是一种异质性疾病,包括了格林森3+5、4+4和5+3肿瘤,并涵盖了很大范围的肿瘤生长模式。

前列腺癌患者中,格林森评分是临床结果的一个重要参数。格林森评分8是一种异质性疾病,包括了格林森3+5、4+4和5+3肿瘤,并涵盖了很大范围的肿瘤生长模式。

最近,有研究人员描述了个体生长模式,并鉴定了格林森评分8前列腺癌患者的预后参数。研究人员分析了1064个根治性前列腺切除样本,记录了个体格林森4和5的生长模式以及导管内癌的存在,并评估生化复发和无转移生存情况。研究发现,140名(13%)患者为格林森评分8,其中76名(54%)为格林森评分3+5,46名(33%)为4+4,18名(13%)为5+3。在格林森评分为4+4的患者中,侵袭性筛状癌和/或导管内癌(n=87,62%)中的发生率率要比3+5 (47%;P<0.001)患者和5+3 (44%;P<0.001)患者更高。110名男性中为格林森模式5:99个案例中为单细胞和/或索状(90%),32个案例中为实体场(29%)。实体场模式5与筛状结果的共存频率(23/32, 72%)要比非实体场模式(36/78, 46%, P=0.02)更高。在包括年龄、前列腺特异性抗原、pT-阶段、手术切缘和淋巴结转移的多变量分析中,筛状结构是无生化复发(HR 2.0, 95%CI 1.0-3.7; P=0.04)和无转移(HR 3.5, 95%CI 1.0-12.3; P=0.05)的一个独立参数。

存在筛状结构的格林森评分8患者分层

最后,研究人员指出,侵袭性筛状癌和/或导管内癌在格林森4+4前列腺癌患者中要比格林森3+5和5+3患者的比例更高,并且是生化复发和转移的一个独立参数。因此,筛状结构有助于格林森评分8前列腺癌患者的风险分层。

原始出处:

Eva Hollemans, Esther I. Verhoef, Chris H. Bangma et al. Cribriform architecture in radical prostatectomies predicts oncological outcome in Gleason score 8 prostate cancer patients. Modern Pathology. July 2020

 

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    2021-02-18 yb6560
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    2020-08-11 jeanqiuqiu

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