根治性前列腺癌病理分期及pT2病理亚分期的意义

Evaluation of TNM staging system and pT2 subdivisions of pathological substaging in patients with clinically localized prostate cancer undergoing radical prostatectomy

目的探讨根治性前列腺癌病理分期及p T2病理亚分期的意义。方法回顾性分析根治性前列腺癌30例,观察肿瘤累及范围、前列腺外及精囊腺侵犯情况,依据2002/2010年TNM分期系统对其行病理分期。结果 30例术前临床评估为局限性前列腺癌,前列腺癌根治术后病理分期:p T2期15例,p T3a期10例,p T3b期5例。p T2期肿瘤中2例为p T2a,13例为p T2c,占p T2期肿瘤的86.7%,无p T2b期肿瘤。结论根治性前列腺癌术后病理分期更加直观和准确,更能够反映肿瘤真实的状态,对预后的评估更有价值,而2002/2010年TNM分期系统对于p T2期肿瘤的亚分期,仅依据肿瘤累及腺叶的范围划分并不完善,需进一步加以改善。

Purpose To evaluate the subclassifications of pT2 diseases in tumor-nodes-metastases （ TNM） staging system for prostate cancer. Methods A retrospective analysis of the medical records of patients who underwent radical prostatectomy （ RP） with the diag-nosis of clinically localized PCa was conducted. Any preoperative therapies, in terms of active surveillance, hormone therapy or radia-tion were exclusion criteria. The RP specimens were completely embedded and histopathologically evaluated for extraprostatic exten-sion, seminal vesicle invasion and staged according to the 2002/2010 TNM staging criteria. Results Using current 2002/2010 TNM staging criteria, in all, 15 cases of the tumors were pT2, 10 cases were pT3a, and 5 cases were pT3a. When subclassification of pT2, 2 cases of the tumors were pT2a, 13 cases of the tumors were pT2c, and none was identified as a pathological T2b tumor. Conclusion The results of the present study suggest that the pathological substaging criteria of organ-confined prostate cancer via methods used in the current 2002/2010 TNM staging system may not be appropriate. Efforts should be made to upgrade the current TNM staging system for prostate cancer.