Skip to main content
Erschienen in: Die Urologie 3/2009

01.03.2009 | CME Weiterbildung • Zertifizierte Fortbildung

Histologische Diagnostik an der Prostatastanzbiopsie

verfasst von: PD Dr. J. Köllermann, G. Sauter

Erschienen in: Die Urologie | Ausgabe 3/2009

Einloggen, um Zugang zu erhalten

Zusammenfassung

Unter dem Druck des zunehmenden PSA-Screenings ist es zu einer fortwährenden Optimierung in der histopathologischen Karzinomdiagnostik gekommen. Bei Einhaltung entsprechender Qualitätsstandards hinsichtlich Biopsieentnahme als auch der Gewebeaufarbeitung ist selbst die Identifizierung kleinster Karzinomherde sicher möglich. Standardisierungsbemühungen in der Gleason-Graduierung sollen zusätzlich helfen, Aussagen hinsichtlich der Tumorbiologie weiter zu präzisieren. Die subtile Diagnose von Karzinomvorstufen bzw. karzinomassoziierter Läsion erlaubt darüber hinaus, zunehmend genauere Vorhersagen zum bestehenden Karzinomrisiko zu treffen. Schwächen bestehen unverändert in der sicheren Erkennung klinisch insignifikanter Karzinome und der Gefahr einer Übertherapie. Hier ist weitere Forschungsaktivität erforderlich.
Literatur
1.
Zurück zum Zitat Haas GP, Delongchamps NB, Jones RF et al (2007) Needle biopsies on autopsy prostates: sensitivity of cancer detection based on true prevalence. J Natl Cancer Inst 99:1484–1489PubMedCrossRef Haas GP, Delongchamps NB, Jones RF et al (2007) Needle biopsies on autopsy prostates: sensitivity of cancer detection based on true prevalence. J Natl Cancer Inst 99:1484–1489PubMedCrossRef
2.
Zurück zum Zitat van der Kwast TH, Lopes C, Santonja C et al (2003) Guidelines for processing and reporting of prostatic needle biopsies. J Clin Pathol 56:336–340CrossRef van der Kwast TH, Lopes C, Santonja C et al (2003) Guidelines for processing and reporting of prostatic needle biopsies. J Clin Pathol 56:336–340CrossRef
3.
Zurück zum Zitat Jiang Z, Wu CL, Woda BA et al (2002) P504S/alpha-methylacyl-CoA racemase: a useful marker for diagnosis of small foci of prostatic carcinoma on needle biopsy. Am J Surg Pathol 26:1169–1174PubMedCrossRef Jiang Z, Wu CL, Woda BA et al (2002) P504S/alpha-methylacyl-CoA racemase: a useful marker for diagnosis of small foci of prostatic carcinoma on needle biopsy. Am J Surg Pathol 26:1169–1174PubMedCrossRef
4.
Zurück zum Zitat McNeal JE, Bostwick DG (1986) Intraductal dysplasia: a premalignant lesion of the prostate. Hum Pathol 17:64–71PubMedCrossRef McNeal JE, Bostwick DG (1986) Intraductal dysplasia: a premalignant lesion of the prostate. Hum Pathol 17:64–71PubMedCrossRef
5.
Zurück zum Zitat Bostwick DG, Brawer MK (1987) Prostatic intra-epithelial neoplasia and early invasion in prostate cancer. Cancer 59:788–794PubMedCrossRef Bostwick DG, Brawer MK (1987) Prostatic intra-epithelial neoplasia and early invasion in prostate cancer. Cancer 59:788–794PubMedCrossRef
6.
Zurück zum Zitat Bostwick DG, Grignon DJ, Hammond ME et al (2000) Prognostic factors in prostate cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 124:995–1000PubMed Bostwick DG, Grignon DJ, Hammond ME et al (2000) Prognostic factors in prostate cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 124:995–1000PubMed
7.
Zurück zum Zitat Epstein JI, Herawi M (2006) Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care. J Urol 175:820–834PubMedCrossRef Epstein JI, Herawi M (2006) Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care. J Urol 175:820–834PubMedCrossRef
8.
Zurück zum Zitat Gokden N, Roehl KA, Catalona WJ et al (2005) High-grade prostatic intraepithelial neoplasia in needle biopsy as risk factor for detection of adenocarcinoma: current level of risk in screening population. Urology 65:538–542PubMedCrossRef Gokden N, Roehl KA, Catalona WJ et al (2005) High-grade prostatic intraepithelial neoplasia in needle biopsy as risk factor for detection of adenocarcinoma: current level of risk in screening population. Urology 65:538–542PubMedCrossRef
9.
Zurück zum Zitat Netto GJ, Epstein JI (2006) Widespread high-grade prostatic intraepithelial neoplasia on prostatic needle biopsy: a significant likelihood of subsequently diagnosed adenocarcinoma. Am J Surg Pathol 30:1184–1188PubMed Netto GJ, Epstein JI (2006) Widespread high-grade prostatic intraepithelial neoplasia on prostatic needle biopsy: a significant likelihood of subsequently diagnosed adenocarcinoma. Am J Surg Pathol 30:1184–1188PubMed
10.
Zurück zum Zitat Wu CL, Yang XJ, Tretiakova M et al (2004) Analysis of alpha-methylacyl-CoA racemase (P504S) expression in high-grade prostatic intraepithelial neoplasia. Hum Pathol 35:1008–1013PubMedCrossRef Wu CL, Yang XJ, Tretiakova M et al (2004) Analysis of alpha-methylacyl-CoA racemase (P504S) expression in high-grade prostatic intraepithelial neoplasia. Hum Pathol 35:1008–1013PubMedCrossRef
11.
Zurück zum Zitat Kronz JD, Shaikh AA, Epstein JI (2001) High-grade prostatic intraepithelial neoplasia with adjacent small atypical glands on prostate biopsy. Hum Pathol 32:389–395PubMedCrossRef Kronz JD, Shaikh AA, Epstein JI (2001) High-grade prostatic intraepithelial neoplasia with adjacent small atypical glands on prostate biopsy. Hum Pathol 32:389–395PubMedCrossRef
12.
Zurück zum Zitat Alsikafi NF, Brendler CB, Gerber GS et al (2001) High-grade prostatic intraepithelial neoplasia with adjacent atypia is associated with a higher incidence of cancer on subsequent needle biopsy than high-grade prostatic intraepithelial neoplasia alone. Urology 57:296–300PubMedCrossRef Alsikafi NF, Brendler CB, Gerber GS et al (2001) High-grade prostatic intraepithelial neoplasia with adjacent atypia is associated with a higher incidence of cancer on subsequent needle biopsy than high-grade prostatic intraepithelial neoplasia alone. Urology 57:296–300PubMedCrossRef
13.
Zurück zum Zitat de Vries SH, Postma R, Raaijmakers R et al (2007) Overall and disease-specific survival of patients with screen-detected prostate cancer in the European randomized study of screening for prostate cancer section Rotterdam. Eur Urol 51:366–374CrossRef de Vries SH, Postma R, Raaijmakers R et al (2007) Overall and disease-specific survival of patients with screen-detected prostate cancer in the European randomized study of screening for prostate cancer section Rotterdam. Eur Urol 51:366–374CrossRef
14.
Zurück zum Zitat D’Amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974CrossRef D’Amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974CrossRef
15.
Zurück zum Zitat Bangma CH, Roemeling S, Schröder FH (2007) Overdiagnosis and overtreatment of early detected prostate cancer. World J Urol 25:3–9PubMedCrossRef Bangma CH, Roemeling S, Schröder FH (2007) Overdiagnosis and overtreatment of early detected prostate cancer. World J Urol 25:3–9PubMedCrossRef
16.
Zurück zum Zitat Epstein JI, Chan DW, Sokoll LJ et al (1998) Nonpalpable stage T1c prostate cancer: prediction of insignificant disease using free/total prostate specific antigen levels and needle biopsy findings. J Urol 160:2407–2411PubMedCrossRef Epstein JI, Chan DW, Sokoll LJ et al (1998) Nonpalpable stage T1c prostate cancer: prediction of insignificant disease using free/total prostate specific antigen levels and needle biopsy findings. J Urol 160:2407–2411PubMedCrossRef
17.
Zurück zum Zitat Jeldres C, Suardi N, Walz J et al (2008) Validation of the contemporary epstein criteria for insignificant prostate cancer in European men. Eur Urol 54:1306–1313PubMedCrossRef Jeldres C, Suardi N, Walz J et al (2008) Validation of the contemporary epstein criteria for insignificant prostate cancer in European men. Eur Urol 54:1306–1313PubMedCrossRef
18.
Zurück zum Zitat Gleason DF (1966) Classification of prostatic carcinomas. Cancer Chemother Rep 50:125–128PubMed Gleason DF (1966) Classification of prostatic carcinomas. Cancer Chemother Rep 50:125–128PubMed
19.
Zurück zum Zitat Djavan B (1998): Gleason scores from prostate biopsies obtained with 18-gauge biopsy needles poorly predict gleason scores of radical prostatectomy specimens. Curr Opin Urol 8:441 Djavan B (1998): Gleason scores from prostate biopsies obtained with 18-gauge biopsy needles poorly predict gleason scores of radical prostatectomy specimens. Curr Opin Urol 8:441
20.
Zurück zum Zitat Koksal IT, Ozcan F, Kadioglu TC et al (2000) Discrepancy between Gleason scores of biopsy and radical prostatectomy specimens. Eur Urol 37:670–674PubMedCrossRef Koksal IT, Ozcan F, Kadioglu TC et al (2000) Discrepancy between Gleason scores of biopsy and radical prostatectomy specimens. Eur Urol 37:670–674PubMedCrossRef
21.
Zurück zum Zitat Pinthus JH, Witkos M, Fleshner NE et al (2006) Prostate cancers scored as Gleason 6 on prostate biopsy are frequently Gleason 7 tumors at radical prostatectomy: implication on outcome. J Urol 176:979–984PubMedCrossRef Pinthus JH, Witkos M, Fleshner NE et al (2006) Prostate cancers scored as Gleason 6 on prostate biopsy are frequently Gleason 7 tumors at radical prostatectomy: implication on outcome. J Urol 176:979–984PubMedCrossRef
22.
Zurück zum Zitat Humphrey PA (2004) Gleason grading and prognostic factors in carcinoma of the prostate. Mod Pathol 17:292–306PubMedCrossRef Humphrey PA (2004) Gleason grading and prognostic factors in carcinoma of the prostate. Mod Pathol 17:292–306PubMedCrossRef
23.
Zurück zum Zitat Pan CC, Potter SR, Partin AW et al (2000) The prognostic significance of tertiary Gleason patterns of higher grade in radical prostatectomy specimens: a proposal to modify the Gleason grading system. Am J Surg Pathol 24:563–569PubMedCrossRef Pan CC, Potter SR, Partin AW et al (2000) The prognostic significance of tertiary Gleason patterns of higher grade in radical prostatectomy specimens: a proposal to modify the Gleason grading system. Am J Surg Pathol 24:563–569PubMedCrossRef
24.
Zurück zum Zitat Epstein JI, Allsbrook WC Jr, Amin MB et al (2005) The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 29:1228–1242PubMedCrossRef Epstein JI, Allsbrook WC Jr, Amin MB et al (2005) The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 29:1228–1242PubMedCrossRef
25.
Zurück zum Zitat Helpap B, Egevad L (2006) The significance of modified Gleason grading of prostatic carcinoma in biopsy and radical prostatectomy specimens. Virchows Arch 449:622–627PubMedCrossRef Helpap B, Egevad L (2006) The significance of modified Gleason grading of prostatic carcinoma in biopsy and radical prostatectomy specimens. Virchows Arch 449:622–627PubMedCrossRef
26.
Zurück zum Zitat Lin KK (2008) Prostate cancer at one end of a needle biopsy core is associated with advanced pathology stage. Mod Pathol 21:166ACrossRef Lin KK (2008) Prostate cancer at one end of a needle biopsy core is associated with advanced pathology stage. Mod Pathol 21:166ACrossRef
27.
Zurück zum Zitat Egan AJ, Bostwick DG (1997) Prediction of extraprostatic extension of prostate cancer based on needle biopsy findings: perineural invasion lacks significance on multivariate analysis. Am J Surg Pathol 21:1496–1500PubMedCrossRef Egan AJ, Bostwick DG (1997) Prediction of extraprostatic extension of prostate cancer based on needle biopsy findings: perineural invasion lacks significance on multivariate analysis. Am J Surg Pathol 21:1496–1500PubMedCrossRef
28.
Zurück zum Zitat Beard CJ, Chen MH, Cote K et al (2004) Perineural invasion is associated with increased relapse after external beam radiotherapy for men with low-risk prostate cancer and may be a marker for occult, high-grade cancer. Int J Radiat Oncol Biol Phys 58:19–24PubMedCrossRef Beard CJ, Chen MH, Cote K et al (2004) Perineural invasion is associated with increased relapse after external beam radiotherapy for men with low-risk prostate cancer and may be a marker for occult, high-grade cancer. Int J Radiat Oncol Biol Phys 58:19–24PubMedCrossRef
29.
Zurück zum Zitat Quinn DI, Henshall SM, Brenner PC et al. (2003) Prognostic significance of preoperative factors in localized prostate carcinoma treated with radical prostatectomy: importance of percentage of biopsies that contain tumor and the presence of biopsy perineural invasion. Cancer 97:1884–1893PubMedCrossRef Quinn DI, Henshall SM, Brenner PC et al. (2003) Prognostic significance of preoperative factors in localized prostate carcinoma treated with radical prostatectomy: importance of percentage of biopsies that contain tumor and the presence of biopsy perineural invasion. Cancer 97:1884–1893PubMedCrossRef
Metadaten
Titel
Histologische Diagnostik an der Prostatastanzbiopsie
verfasst von
PD Dr. J. Köllermann
G. Sauter
Publikationsdatum
01.03.2009
Verlag
Springer-Verlag
Erschienen in
Die Urologie / Ausgabe 3/2009
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-009-1966-8

Weitere Artikel der Ausgabe 3/2009

Die Urologie 3/2009 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.