前立腺癌初診時生検組織と全摘標本組織及びリンパ節転移組織の比較 : 構築分類(WHO分類)を基にして

Abstract

前立腺癌60症例について, 生検組織と前立腺全摘標本組織及びリンパ節転移組織を検討した.生検組織と全摘標本組織では6組織型要素の内微小腺管型を除く5組織型要素でそれぞれ有意の相関が認められた.アンドロゲン依存性のある要素小単純腺管型, MIC, 篩状腺管型のみからなる症状と非依存性要素融合腺管型, 充実髄様増殖型, 索状増殖型を含む症例に分けてみると, 78.3%の症例が生検組織と全摘標本組織で一致していた

The histological characteristics were comparatively analyzed among biopsy specimens, surgically removed prostates and metastatic lymph nodes obtained from 60 patients with prostatic adenocarcinoma treated by radical prostatectomy. According to the WHO-Mostifi's classification, the proportion of the 6 histologic components, large and/or small simple glands (LSG), micro-glands (MIC), cribriorm (CRB), fused glands (FUS), medullary/solid (MED) and columns-cords/trabecular (C-C), was determined semiquantitatively. LSG, MIC, and CRB are androgen-sensitive components, while FUS, MED and C-C are androgen-refractory components. The proportions of 5 histologic components excluding MIC were similar in the biopsy and prostate specimens. In 78.3% of the patients, the presence (or absence) of androgen-refactory components in the biopsy specimens coincided with that in the prostate specimens. However, the histologic except for the C-C component. Metastatic lymph nodes contained androgen-refactory components in all cases and tended to have more CRB and FUS and fewer LSG. The histology of the needle biopsy specimens may reflect that of the prostate glands, and may serve as a valuable parameter for determining therapeutic modalities. In addition, androgen-refactory components are frequently present in lymph node metastasis.