1991 Volume 82 Issue 6 Pages 967-975
Most of the previous publications have focused mainly on structural atypism (SAT) or differentiation in the studies on histopathological findings of prostate carcinoma. We studied nuclear anaplasia (NAN) as well as SAT in prostate carcinoma, comparing with differentiation grade or Gleason's pattern, to find NAN's clinical implication. We also compared histopathological findings of prostate carcinoma in our cases with those in U. S. A.
Analysis of NAN grade and SAT grade distribution in stages revealed a correlation between the grades and the stages, in which SAT1 or NAN1 decreased while SAT3 or NAN3 increased in their frequencies as stage progressed. A similar correlation was found between ‹SAT+NAN› grade and stage.
While NAN grade and SAT grade agreed with each other in 70% of the patients with prostate carcinoma, that was not the case in the remaining patients. This suggested a complementary relationship between NAN grade and SAT grade in some patients. A similar relationship was found between NAN grade and Gleason's pattern. These results suggest that, in a non-negligible number of patients, the NAN grade does not agree with the SAT grade or Gleason's pattern which is defined by atypism in the glandular structure.
Disease-specific survival in each SAT grade could be further defined by the NAN grade. For example, in both SAT2 and SAT3, NAN3 tended to have a poorer prognosis than NAN2. Thus, NAN grading system would furnish more accurate information to predict the patients' clinical course.
Prostate carcinomas in our series had a higher frequency of moderately or poorly differentiated type or Gleason's sum than those in the ACS study or the VACURG study. These results indicate a more malignant tendecny of prostate carcinoma in Japan
