Stage D2前立腺癌症例の検討

Abstract

1981年1月よりの10年8ヵ月間に, 組織学的に前立腺癌と診断されたうちstage D2と診断された45例に対して臨床的検討を加えた。1)初診時よりstage D2と診断されたものは38例であり, うち13例が再燃を認め, 6例は初回治療に反応しなかった。経過観察中にstage D2へと再燃進行したものが7例あった。2)初回治療としては内分泌および化学療法の併用が最も多く, 去勢術は13例に施行された。3)組織学的分化度の検討では低分化腺癌が最も多く, 高分化腺癌は6.7%のみであった。4)骨転移進展度による分類では, EOD 1が26例と最も多く, ついでEOD 2が13例であったが, 今回の検討ではEOD分類による生存率の差は認められなかった。5)前立腺腫瘍マーカーの陽性率は, PAP 62.6%, γ-Sm 66.6%, PA 90.6%とPAがもっとも高く, PAが正常値の2倍以上を示したものが75%認められた

Between 1981 to 1991, 126 patients were diagnosed with prostatic cancer from histological reports. Stage D2 prostatic cancer was confirmed in 38 of these cases at the time of the initial diagnosis (group alpha). Of 38 patients in group alpha, 13 had recurrence of disease after a good response to the initial treatment, 19 had no recurrence after the treatment and the other 6 patients showed no response to the initial treatment for prostatic cancer. Seven patients showed progression of the disease to stage D2 during the observation period (group beta). These forty-five patients with stage D2 prostatic cancer were analyzed. Poorly differentiated adenocarcinoma was the most frequently observed histological grade, followed by moderately differentiated. The grade of the extent of the disease (EOD) on bone scan was classified as EOD I in 26, EOD II in 13 and EOD III in 4, with no significant differences in the survival rate found among these groups. The sensitivity rate of prostate specific antigen was higher than that of other serum tumor markers. Twenty-three patients died during the observation period. 18 of the 23 died of prostatic cancer.