Abstract
Prognosis and choice of treatment of adenocarcinoma of the prostate (ADCP) directly depend on the numerous of predictive factors, among which the most important are summary histological tumor grade (Gleason score, which is the sum of the first and second dominant histological grade) and clinical stage. According to recent research these factors include androgen tissue status and degree of neuroendocrine differentiation. The importance of the first and second dominant histological grade becomes particularly important in ADCP Gleason score 7. Tumors with worse prognosis considered to be ADCP of higher Gleason score, the advanced clinical stage, androgen independent tumors and tumors that show a higher degree of neuroendocrine differentiation. The aim of the study was to determine the predictive significance of ADCP Gleason score 7 (3+4) and ADCP Gleason score 7 (4+3) in relation to clinical stage, androgen tissue status and degree of focal neuroendocrine differentiation. The study included 33 ADCP of Gleason score 7,26 (78.79%) ADCP 7 (3+4) and 7 (21.21%) ADCP 7 (4+3). All tumors are most often diagnosed with stage D2, when there are already distant metastases. ADCP of Gleason score 7 (4+3) were diagnosed more often at this stage, among them there are more androgen independent tumors and they show a greater degree of focal neuroendocrine differentiation. All the results are in accordance with data from the literature suggesting that ADCP of Gleason score 7 (4+3) have a worse prognosis than ADCP of Gleason score 7 (3 +4).
Highlights
Osim patohistološke dijagnoze adenokarcinoma prostate na rutinskim mikroskopskim preparatima određen je i Gleason score na osnovu standardizovanih procedura
U ispitivanom uzorku pacijenata iz ovog istraživanja najčešći klinički stadijum bio je D2 (45,45%), zatim B3 (21,21%) i C2 (18,18%)
Postoji signifikantna verovatnoća od preko 70% da će se imunoreaktivnost na serotonin naći na 10 ćelija/10 polja velikog uvećanja (PVU) (Studentov t-test, t=4,65; p
Summary
Mijović M.1, Vukićević D.1, Đerković B.1, Nedeljković V.1, Vitković L.2 1 Institut za patologiju, Medicinski fakultet Priština, Kosovska Mitrovica 2 Institut za histologiju, Medicinski fakultet Priština, Kosovska Mitrovica. Prognoza i izbor terapije adenokarcinoma prostate (ADKP) direktno zavise od brojnih prediktivnih faktora, među kojima su najznačajniji zbirni histološki gradus tumora (Gleason score, koji predstavlja zbir prvog i drugog dominantnog histološkog gradusa) i klinički stadijum. Smatra se da goru prognozu imaju ADKP višeg Gleason score-a, uznapredovalog kliničkog stadijuma, androgen nezavisni tumori i tumori koji pokazuju veći stepen neuroendokrine diferencijacije. Prevalenca ovog karcinoma u autopsijskim studijama progresivno raste sa godinama starosti i kreće se od manje od 10% kod muškaraca između 40-e i 50-e godine do između 30% i 50% kod muškaraca starijih od 80 godina, ali se tada radi o klinički neprepoznatljivim, tzv. Osnovu ovog sistema gradiranja predstavlja 5 histoloških slika ili gradusa koje na malom mikroskopskom povećanju (10-40x), obuhvataju analizu poremećaja žlezdane arhitekture: oblika, veličine i stepena glandularne diferencijacije i stromalne invazije karcinoma prostate, ali ne i stepen nuklearne anaplazije [27,17]. Gleason score od 2 do 4 odgovara dobro diferentonanom karcinomu prostate, od 5 do 7 srednje do slabo diferentovanom karcinomu prostate, a od 8 do 10 slabo diferentovanom karcinomu prostate [27,17]
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