MORPHOMETRIC STUDIES OF INTRA-PROSTATIC VOLUME RELATIONSHIPS IN LOCALIZED PROSTATIC-CANCER

Objectives To further characterize patterns of tumour growth and the d istribution of markers for the aggressiveness of prostate cancer by as sessing the relationships among the volume of the 'index' tumour and t hat of the remaining foci, with pathological !(pT) stage, histological grade and DNA ploidy, and with the amount of low- and high-grade pros tatic intraepithelial neoplasia (PIN). Materials and methods Eighty-ei ght step-sectioned total prostatectomy specimens were analysed. The Gl eason score, tumour stage and DNA ploidy (by now cytometry) of multipl e samples were determined. Tumour and PIN areas were outlined and thei r volumes estimated by computerized planimetry. Results The pT stage, Gleason sum and DNA non-diploidy increased, and PIN volumes decreased, with increasing volume of the index tumour focus (P<0.01), but did no t differ significantly between uni-and multifocal tumours. However, PI N volumes were significantly larger in multifocal cases with an index tumour volume of >3 mi than in unifocal tumours >3 mL(P<0.05), Small v olume, unifocal tumours had little PIN, The most malignant features of each case were always represented in the index tumour but not general ly in the remaining foci. Conclusions The volume distribution, related to multicentricity and its concomitant PIN volumes, indicates that la rge index tumours, uni-or multifocal, of medium or high grade, are ass ociated with low PIN volumes. However, multifocal medium-and high-grad e tumours with small index tumour volumes ha ire higher PIN volumes. S mall, single tumours are of low-grade and may represent the slowly pro gressing cancers possibly resembling those found in autopsy studies.