前立腺癌の組織分類についてGleason分類の検討

Abstract

1973年1月から13年間に, 経験した未治療の前立腺癌98症例について, 取扱い規約およびGleasonの分類に基づいて組織学的に分類し, 予後との関係について検討した.1) Gleason分類のscoreは取扱い規約の分類とよい相関を示した.2) Gleason分類のscoreは臨床病期が進むにつれて高くなる傾向を示したが, stage Aでscoreが10の症例が1例認められ, stage Dでscoreが3の症例を認めた.3) Gleason分類のscoreが低い症例の生存率は最もよかったが, 各scoreの群間では必ずしも生存率に有意差を認めなかった

Gleason histologic grading for prostatic carcinoma was evaluated in a retrospective analysis. The present study comprises 98 cases of prostatic adenocarcinoma followed from January, 1973 to December, 1985. Histological materials were obtained by needle biopsy, transurethral resection or by suprapubic prostatectomy. Such slides were examined by a pathologist without previous knowledge of the patients and were assigned according to the General Rules for Clinical and Pathological Studies on Prostatic Cancer (1985) or Gleason system. Most patients fell within a Gleason score of 6, 7 and 8, and had a correspondingly high stage tumors. The survival rate for the patients was analyzed according to Gleason score. Because of the small numbers of patients some scores were combined. There were no cancer deaths for the 15 patient with a Gleason score under 5. Patients with a higher score (9-10) had a poorer prognosis (32% of survival rate at 2, 234 days), but there was no significant correlation between a Gleason score of 6, 7 or 8, or that of a higher score (9-10) and survival rate.