Paweł1968 pisze:czy to co zostało stwierdzone w zapisie histop. zostało usunięte wraz z torebką gruczołu?
Pawel, pomyśl logicznie, przecież to co nie zostało usunięte i nie wylądowało na stole laboratoryjnym nie mogłoby być opisane przez patologa.
Co do wpływu PNI na ryzyko wystąpienia BCR/BR - opinie są podzielone i możesz wybierać między 2 wersjami, b. optymistyczną i b. pesymistyczną.
Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer?
Abstract
Introduction:
The ability of perineural invasion (PNI) in radical prostatectomy (RP) specimens to predict biochemical recurrence (BCR) is unclear.
This study investigates this controversial question in a large cohort.
Methods:
A retrospective analysis was undertaken of prospectively collected data from 1497 men who underwent RP (no neoadjuvant therapy) for clinically localized prostate cancer.
The association of PNI at RP with other clinicopathological parameters was evaluated. The correlation of clinicopathological factors and BCR (defined as prostate-specific antigen [PSA] >0.2 ng/mL) was investigated with univariable and multivariable Cox regression analysis in 1159 men.
Results:
PNI-positive patients were significantly more likely to have a higher RP Gleason score, pT3 disease, positive surgical margins, and greater cancer volume (p < 0.0005).
The presence of PNI significantly correlated with BCR on univariable (hazard ratio 2.30, 95% confidence interval 1.50–3.55, p < 0.0005),
but not multivariable analysis (p = 0.602).
On multivariable Cox regression analysis the only independent prognostic factors were preoperative PSA, RP Gleason score, pT-stage, and positive surgical margin status. These findings are limited by a relatively short follow-up time and retrospective study design.
Conclusions:
PNI at RP is not an independent predictor of BCR. Therefore, routine reporting of PNI is not indicated.
Future research should be targeted at the biology of PNI to increase the understanding of its role in prostate cancer progression.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439219/
Effects of perineural invasion in prostate needle biopsy on tumor grade and biochemical recurrence rates after radical prostatectomy - ScienceDirect
Abstract
To predict local invasive disease before retropubic radical prostatectomy(RRP), the correlation of perineural invasion (PNI) on prostate needle biopsy (PNB) and RRP pathology data and the effect of PNI on biochemical recurrence (BR) were researched.
For patients with RRP performed between 2005 and 2014, predictive and pathologic prognostic factors were assessed.
Initially all and D'Amico intermediate-risk group patients were comparatively assessed in terms of being T2 or T3 stage on RRP pathology, positive or negative for PNI presence on PNB and positive or negative BR situation.
Additionally the effect of PNI presence on recurrence-free survival (RFS) rate was investigated.
When all patients are investigated, multivariate analysis observed that in T3 patients PSA, PNB Gleason score (GS) and tumor percentage were significantly higher;
in PNI positive patients PNB GS, core number and tumor percentage were significantly higher
and
in BR positive patients PNB PNI positivity and core number were significantly higher
compared to T2, PNI negative and BR negative patients, separately (p < 0.05).
When D'Amico intermediate-risk patients are evaluated,
for T3 patients PSA and PNB tumor percentage;
for PNI positive patients PNB core number and tumor percentage;
and
for BR positive patients PNB PNI positivity were significantly higher compared to T2, PNI negative and BR negative patients, separately (p < 0.05).
Mean RFS in the whole patient group was 56.4 ± 4.2 months for PNI positive and 96.1 ± 5.7 months for negative groups.
In the intermediate-risk group, mean RFS was 53.7 ± 5.1 months for PNI positive and 100.3 ± 7.7 months for negative groups (p < 0.001). PNI positivity on PNB was shown to be an important predictive factor for increased T3 disease and BR rates and reduced RFS.
https://www.sciencedirect.com/science/a ... 1X17304175
