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首页> 外文期刊>BJU international >Characteristics of incidental prostatic adenocarcinoma in contemporary radical cystoprostatectomy specimens.
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Characteristics of incidental prostatic adenocarcinoma in contemporary radical cystoprostatectomy specimens.

机译：当代根治性膀胱前列腺切除术标本中偶然性前列腺腺癌的特征。

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OBJECTIVES: To investigate the relationship between prostate-specific antigen (PSA) level and tumour volume for incidental adenocarcinoma of the prostate found in cystoprostatectomy (CP) specimens, and to analyse the incidence of clinically significant prostate cancers in CP specimens and the biochemical recurrence of incidental prostate cancers on short-term follow up. PATIENTS AND METHODS: Complete data from 97 of 105 prostates from CP specimens were available. Prostates were thoroughly analysed and sectioned at 2 mm intervals. PSA levels and the findings at digital rectal examination before surgery were obtained prospectively. None of the patients had any evidence of prostate cancer before CP. RESULTS: Incidental prostate cancer was detected in 58 of 97 (60%) of the CP specimens; of these, 31 (53%) were significant according to the definition of Stamey et al. There was a weak correlation between tumour volume and PSA level, weighted solely by the four larger-volume cancers. The median PSA level for patients with and without prostate cancer was not significantly different (3.1 vs 1.1 ng/mL, P = 0.06). The follow-up of the 35 patients alive with prostate cancer showed four PSA recurrences (PSA >0.02 ng/mL) with one distant metastasis after a median follow-up of 3 years. None of the patients with insignificant tumours developed biochemical recurrence. CONCLUSIONS: The weak correlation between PSA level and tumour volume in these patients supports the argument that PSA is largely produced by benign prostatic hyperplasia and is therefore a poor screening tool for asymptomatic healthy men. Most incidental prostate cancers in CP specimens are significant, contrary to previous analyses, but have little practical importance in terms of oncological outcome.
机译：目的：调查在膀胱前列腺切除术（CP）标本中发现的前列腺偶发性腺癌的前列腺特异性抗原（PSA）水平与肿瘤体积之间的关系，并分析在CP标本中临床上重要的前列腺癌的发生率和前列腺癌的生化复发短期随访中发现偶然的前列腺癌。患者和方法：可从CP标本中获得105个前列腺中的97个的完整数据。对前列腺进行彻底分析并以2 mm的间隔切片。前瞻性地获得了PSA水平和术前直肠指检的结果。在CP之前，没有患者有前列腺癌的任何证据。结果：在97个CP标本中有5​​8个（60％）检出了偶然的前列腺癌。根据Stamey等人的定义，其中31个（53％）显着。肿瘤体积与PSA水平之间的相关性较弱，仅按四种较大体积的癌症加权。有和没有前列腺癌的患者的中位PSA水平无显着差异（3.1 vs. 1.1 ng / mL，P = 0.06）。对35例活着的前列腺癌患者进行的随访显示，中位随访3年后，有4例PSA复发（PSA> 0.02 ng / mL）并伴有远处转移。肿瘤微不足道的患者均未发生生化复发。结论：这些患者的PSA水平与肿瘤体积之间的相关性较弱，支持了以下观点：PSA主要由良性前列腺增生产生，因此对于无症状健康男性而言筛查工具较差。与先前的分析相反，CP标本中大多数偶发的前列腺癌是重要的，但就肿瘤学结局而言却没有实际意义。

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