前立腺移行上皮癌症例および膀胱移行上皮癌の前立腺浸潤例の検討 II) 膀胱移行上皮癌の前立腺浸潤例との対比
前立腺移行上皮癌は, 膀胱移行上皮癌の前立腺浸潤と病理学的にも鑑別が難しいことが時にある. 頻度的には膀胱癌の前立腺浸潤によるものの方が原発性前立腺移行上皮癌よりも多いことより, 本報ではその検討を行った. 膀胱移行上皮癌に対して膀胱前立腺全摘除術を施行した173症例の前立腺組織を調べ, 前立腺に何ら悪性所見を認めない“病変”群と, 前立腺に膀胱移行上皮癌の浸潤を認める“前立腺浸潤”群の2群に分け, それらの臨床及び病理所見を検討した. その結果,“前立腺浸潤群”は“病変”群と比べ, (1)排尿困難が多い, (2)浸潤性癌が多く, 細胞の異型度が強い, (3)尿道再発が多いという特徴がみられ,...
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| Published in | 日本泌尿器科學會雑誌 Vol. 78; no. 8; pp. 1372 - 1378 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本泌尿器科学会
20.08.1987
The Japanese Urological Association 社団法人日本泌尿器科学会 |
| Online Access | Get full text |
| ISSN | 0021-5287 1884-7110 |
| DOI | 10.5980/jpnjurol1928.78.8_1372 |
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| Abstract | 前立腺移行上皮癌は, 膀胱移行上皮癌の前立腺浸潤と病理学的にも鑑別が難しいことが時にある. 頻度的には膀胱癌の前立腺浸潤によるものの方が原発性前立腺移行上皮癌よりも多いことより, 本報ではその検討を行った. 膀胱移行上皮癌に対して膀胱前立腺全摘除術を施行した173症例の前立腺組織を調べ, 前立腺に何ら悪性所見を認めない“病変”群と, 前立腺に膀胱移行上皮癌の浸潤を認める“前立腺浸潤”群の2群に分け, それらの臨床及び病理所見を検討した. その結果,“前立腺浸潤群”は“病変”群と比べ, (1)排尿困難が多い, (2)浸潤性癌が多く, 細胞の異型度が強い, (3)尿道再発が多いという特徴がみられ, これは第1報の原発性前立腺移行上皮癌の特徴と極めて類似していた. さらに, 前立腺移行上皮癌の発生起源, その進展, さらに膀胱移行上皮癌, その他の尿路上皮癌との関係について, 解剖学的, 発生学的見地, 及び発癌のメカニズムより検討した. 治療の実際的な観点からすると, 前立腺に移行上皮癌を認めた場合は, 原発性移行上皮癌の存在を認めるものの, 膀胱癌 (又は多発性尿路上皮癌) の1特殊型の可能性も強く, 前立腺以外の尿路を十分検索したうえで, 膀胱前立腺全摘除術±尿道摘除術, 骨盤内リンパ節郭清術, 術後全身化学療法をおこなうのが良いと考えた. |
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| AbstractList | 前立腺移行上皮癌は,膀胱移行上皮癌の前立腺浸潤と病理学的にも鑑別が難しいことが時にある.頻度的には膀胱癌の前立腺浸潤によるものの方が原発性前立腺移行上皮癌よりも多いことより,本報ではその検討を行った.膀胱移行上皮癌に対して膀胱前立腺全摘除術を施行した173症例の前立腺組織を調べ,前立腺に何ら悪性所見を認めない"病変なし''群と,前立腺に膀胱移行上皮癌の浸潤を認める"前立腺浸潤"群の2群に分け,それらの臨床及び病理所見を検討した.その結果,"前立腺浸潤群"は"病変なし"群と比べ,(1)排尿困難が多い,(2)浸潤性癌が多く,細胞の異型度が強い,(3)尿道再発が多いという特徴がみられ,これは第1報の原発性前立腺移行上皮癌の特徴と極めて類似していた.さらに,前立腺移行上皮癌の発生起源,その進展,さらに膀胱移行上皮癌,その他の尿路上皮癌との関係について,解剖学的,発生学的見地,及び発癌のメカニズムより検討した.治療の実際的な観点からすると,前立腺に移行上皮癌を認めた場合は,原発性移行上皮癌の存在を認めるものの,膀胱癌(又は多発性尿路上皮癌)の1特殊型の可能性も強く,前立腺以外の尿路を十分検索したうえで,膀胱前立腺全摘除術±尿道摘除術,骨盤内リソバ節郭清術,術後全身化学療法をおこなうのが良いと考えた.
Primary transitional cell carcinoma of the prostate and the prostatic involvement by the transitional cell carcinoma of the urinary bladder are sometimes difficult to differentiate even in terms of histology. Moreover, the prostatic involvement by transitional cell carcinoma of the urinary bladder is more frequently observed than the primary transitional cell carcinoma of the prostate. Therefore, in this report, the characteristics of the prostatic involvement by transitional cell carcinoma of the urinary bladder was examined in 173 cystoprostatectomized specimens for bladder cancer. The prostatic specimens were examined by step sectioning and were divided into "no malignancy" group and "prostatic involvement" group. Significant clinical and pathological findings in the "prostatic involvement" group were; (1) dysuria was more frequently observed, (2) invasive carcinoma was more prominent, (3) urethral recurrence was more frequently seen. The above findings were also coincident with the charactristics of the primary transitional cell carcinoma of the prostate. From the case reports in the first report and their comparison with adenocarcinoma of the prostate, and transitional cell carcinoma of the urinary bladder, the origin and development of transitional cell carcinoma of the prostate, and the relationship with transitional cell carcinoma in the urinary bladder as well as multiple urothelial carcinoma in the urinary tract were discussed from the anatomic, embryonic and carcinogenic standpoint. From the practical, therapeutic view point, we admit the concept of primary transitional cell carcinoma of the prostate, but at the same time we must also think about the possibility that the case is a special type of transitional cell carcinoma in the urinary bladder or prostatic involvement by multiple urinary tract cancer. The most suitable treatment appears to be cystoprostatectomy with or without urethrectomy and pelvic lymph nodes dissection. When one-stage urethrectomy is not performed, it is mandatory to periodically check the possibility of reccurence in the urethra in these cases. 前立腺移行上皮癌は, 膀胱移行上皮癌の前立腺浸潤と病理学的にも鑑別が難しいことが時にある. 頻度的には膀胱癌の前立腺浸潤によるものの方が原発性前立腺移行上皮癌よりも多いことより, 本報ではその検討を行った. 膀胱移行上皮癌に対して膀胱前立腺全摘除術を施行した173症例の前立腺組織を調べ, 前立腺に何ら悪性所見を認めない“病変”群と, 前立腺に膀胱移行上皮癌の浸潤を認める“前立腺浸潤”群の2群に分け, それらの臨床及び病理所見を検討した. その結果,“前立腺浸潤群”は“病変”群と比べ, (1)排尿困難が多い, (2)浸潤性癌が多く, 細胞の異型度が強い, (3)尿道再発が多いという特徴がみられ, これは第1報の原発性前立腺移行上皮癌の特徴と極めて類似していた. さらに, 前立腺移行上皮癌の発生起源, その進展, さらに膀胱移行上皮癌, その他の尿路上皮癌との関係について, 解剖学的, 発生学的見地, 及び発癌のメカニズムより検討した. 治療の実際的な観点からすると, 前立腺に移行上皮癌を認めた場合は, 原発性移行上皮癌の存在を認めるものの, 膀胱癌 (又は多発性尿路上皮癌) の1特殊型の可能性も強く, 前立腺以外の尿路を十分検索したうえで, 膀胱前立腺全摘除術±尿道摘除術, 骨盤内リンパ節郭清術, 術後全身化学療法をおこなうのが良いと考えた. |
| Author | 鳶巣, 賢一 高井, 計弘 岸, 紀代三 垣添, 忠生 松本, 恵一 |
| Author_FL | Matsumoto Keiichi Kishi Kiyozo Kakizoe Tadao Tobisu Ken-ichi Takai Kazuhiro |
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| Author_xml | – sequence: 1 fullname: 垣添, 忠生 organization: 国立がんセンター泌尿器科 – sequence: 1 fullname: 鳶巣, 賢一 organization: 国立がんセンター泌尿器科 – sequence: 1 fullname: 高井, 計弘 organization: 国立がんセンター泌尿器科 – sequence: 1 fullname: 岸, 紀代三 organization: 国立がんセンター病理 – sequence: 1 fullname: 松本, 恵一 organization: 現 国立横須賀病院 |
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| DocumentTitleAlternate | A COMPARATIVE STUDY WITH THE CASES OF TRANSITIONAL CELL CARCINOMA OF THE PROSTATE AND THE CASES WITH PROSTATIC INVOLVEMENT OF TRANSITIONAL CELL CARCINOMA OF THE URINARY BLADDER : II) Cases with Prostatic Involvement of Transitional Cell Carcinoma of the Urinary Bladder |
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| References | 15) Kirk, D., Savage, A., Makepeace, A. R. and Gostelow, B. E.: Transitional cell carcinoma involving the prostate. —An unfavourable prognostic sign in the management of bladder cancer. Brit. J. Urol., 53, 610-612, 1981. 17) Kirk, D., Hinton, C. E. and Sahaldon, C.: Transitional cell carcinoma of the prostate. Brit. J. Urol., 51, 575-578, 1979. 26) 堀内誠三, 保坂義雄, 親松常男, 中沢速和, 小松秀樹, 藤目真, 吉野伸二: 前立腺潜在性癌の治療とその成績. 日泌尿会誌, 76, 1006-1014, 1985. 2) Algaba, F., Santaularia, J. M., Lamas, M. and Ayala, G.: Transitional cell carcinoma of the prostate. Eur. Urol., 11, 87-90, 1985. 8) Catalona, W. J.: Prostate cancer. Groune & Stratton, Inc. Orlando, 1984. 23) Kakizoe, T., Fujita, J., Murase, T., Matsumoto, K. and Kishi, K.: Transitional cell carcinoma of the bladder in patients with renal pelvic and ureteral cancer. J. Urol., 124, 17-19, 1980. 11) Catalona, W. J. and Scott, W. W.: Carcinoma of the prostate: A review. J. Urol., 119, 1-8, 1978. 21) Howe, G. R., Bunch, J. D., Miller, A. B., Cook, G. M., Esteve, J., Morrison, B., Gordon, P., Chambers, L. W., Fodor, G. and Winsor, G. M.: Tobacco use, occurpation, coffee, various nutrients, and bladder cancer. J. Natl. Cancer Inst., 64, 701-703, 1980. 28) Sternbergm, C. N., Yagoda, A., Scher, H. I., Watson, R. C., Ahmed, T., Weiselberg, L. R., Geller, N., Hollander, P. S., Herr, H. W., Sogani, P. C., Morse, M. J. and Whitmore, W. F.: Preliminary results of M-VAC(Methotrexate, Vinblastine, Doxorubicin and Cis-platin) for transitional cell carcinoma of the urothelium. J. Urol., 133, 403-407, 1985. 4) Karpas, C. M. and Moumgins, B.: Primary transitional cell carcinoma of prostate gland: possible pathogenesis and relationship to reserve cell hyperplasia of prostatic periuretheral ducts. J. Urol., 101, 201-205, 1969. 3) Alexander, S. J., Lee, S. S. and Bekhrad, A.: Transitional cell carcinoma of the prostate: Response to treatment with cis-platinum and cyclophnosphamide. J. Urol., 131, 975-977, 1984. 9) Ullmann, A. S. and Ross, O. A.: Hyperplasia, atypism and carcinoma in situ in prostatic periurethral glands. Amer. J. Clin. Path., 47, 497-505, 1967. 18) 長船匡男, 伊東博, 有馬正明, 松田稔, 水谷修太郎: 前立腺におよぶ原発性膀胱上皮内癌. 日泌尿会誌, 17, 257-263, 1980. 19) Johnson, D. E., Hogan, J. M. and Ayala, A. G.: Transitional cell carcinoma of the prostate. A clinical morphological study. Cancer, 29, 287-293, 1972. 20) Schujman, E., Mukamel, E., Siutzaker, D., Mor, C. and Seruadio, C.: Prostatic trantional cell carcinoma: Concept of its pathogenesis and classification. Israel., J. Med. Sciences., 19, 794-800, 1983. 5) Schellhammer, P. F., Bean, M. A. and Whitmore, W. F. Jr.: Prostatic involvement by transitional cell carcinioma: Pathogenesis, patterns and prognosis. J. Urol., 118, 399-403, 1977. 25) 垣添忠生: 膀胱癌の臨床像にもとづいた基礎的研究. 日癌治, 20, 623-633, 1985. 1) Wolfe, J. H. N. and Lloyd-Davies, R. W.: The management of transitional cell carcinoma in the prostate. Brit. J. Urol., 53, 253-257, 1981. 6) Chibber, P. J., Mcintyre, M. A., Hindmarsh, J. R., Hargreave, T. B., Newsam, J. E. and Chisholm, G. D.: Transitional cell carcinoma involving the prostate. Brit. J. Urol., 53, 605-609, 1981. 14) Ende, N., Woods, L. P. and Shelley, H. S.: Carcinoma originating in ducts surrounding the prostatic urethra. Amer. J. Clin. Path., 40, 183-189, 1963. 13) 岡部勉, 野田進士, 江藤耕作, 入江康司: 前立腺原発性移行上皮癌の1例. 西日泌尿, 43, 963-968, 1981. 16) Araki, H., Mishina, T., Miyakoda, K., Fujiware, T. and Kobayashi, T.: An epidemiological survey of prostatic cancer from the annual of the pathological autopsy cases in Japan. Tohoku J. Exp. Med., 130, 159-164, 1980. 27) Carmichael, J., Cornbleet, M. A., MacDougall, R. H., Allan, S. G., Duncan, W., Chisholm, G. D. and Smyth, J. F.: Cis-platin and methotrexate in the treatment of transitional cell carcinoma of the urinary tract. Brit. J. Urol., 57, 299-302, 1985. 12) Greene, L. F., O'dea, M. J. and Dockerty, M. B.: Primary transitional cell carcinoma of the prostate. J. Urol., 116, 761-763, 1976. 7) 泌尿器科・病理, 膀胱癌取扱い規約: 第1版. 金原出版, 東京, 1985. 24) 仲田浄治郎, 増田富士男, 大石幸彦, 小路良, 陳瑞昌, 大西哲郎, 町田豊平, 佐々木忠正, 谷野誠, 古里征国, 鈴木良二, 藍沢茂雄, 石川栄世: 腎孟腫瘍に併発する尿管, 膀胱腫瘍の検討. 日泌尿会誌, 73, 584-589, 1982. 22) Morroson, A. S.: Advances in the etiology of urothelial cancer. Urol. Clin. North. Amer., 11, 557-566, 1984. 10) Sawczuk, I., Tannenbaum, M., Olsson, C. A. and White, R. V.: Primary transitional cell carcinoma of prostatic periurethral ducts. Urology, 25, 339-343, 1985. |
| References_xml | – reference: 24) 仲田浄治郎, 増田富士男, 大石幸彦, 小路良, 陳瑞昌, 大西哲郎, 町田豊平, 佐々木忠正, 谷野誠, 古里征国, 鈴木良二, 藍沢茂雄, 石川栄世: 腎孟腫瘍に併発する尿管, 膀胱腫瘍の検討. 日泌尿会誌, 73, 584-589, 1982. – reference: 22) Morroson, A. S.: Advances in the etiology of urothelial cancer. Urol. Clin. North. Amer., 11, 557-566, 1984. – reference: 13) 岡部勉, 野田進士, 江藤耕作, 入江康司: 前立腺原発性移行上皮癌の1例. 西日泌尿, 43, 963-968, 1981. – reference: 14) Ende, N., Woods, L. P. and Shelley, H. S.: Carcinoma originating in ducts surrounding the prostatic urethra. Amer. J. Clin. Path., 40, 183-189, 1963. – reference: 7) 泌尿器科・病理, 膀胱癌取扱い規約: 第1版. 金原出版, 東京, 1985. – reference: 17) Kirk, D., Hinton, C. E. and Sahaldon, C.: Transitional cell carcinoma of the prostate. Brit. J. Urol., 51, 575-578, 1979. – reference: 19) Johnson, D. E., Hogan, J. M. and Ayala, A. G.: Transitional cell carcinoma of the prostate. A clinical morphological study. Cancer, 29, 287-293, 1972. – reference: 18) 長船匡男, 伊東博, 有馬正明, 松田稔, 水谷修太郎: 前立腺におよぶ原発性膀胱上皮内癌. 日泌尿会誌, 17, 257-263, 1980. – reference: 25) 垣添忠生: 膀胱癌の臨床像にもとづいた基礎的研究. 日癌治, 20, 623-633, 1985. – reference: 28) Sternbergm, C. N., Yagoda, A., Scher, H. I., Watson, R. C., Ahmed, T., Weiselberg, L. R., Geller, N., Hollander, P. S., Herr, H. W., Sogani, P. C., Morse, M. J. and Whitmore, W. F.: Preliminary results of M-VAC(Methotrexate, Vinblastine, Doxorubicin and Cis-platin) for transitional cell carcinoma of the urothelium. J. Urol., 133, 403-407, 1985. – reference: 15) Kirk, D., Savage, A., Makepeace, A. R. and Gostelow, B. E.: Transitional cell carcinoma involving the prostate. —An unfavourable prognostic sign in the management of bladder cancer. Brit. J. Urol., 53, 610-612, 1981. – reference: 2) Algaba, F., Santaularia, J. M., Lamas, M. and Ayala, G.: Transitional cell carcinoma of the prostate. Eur. Urol., 11, 87-90, 1985. – reference: 10) Sawczuk, I., Tannenbaum, M., Olsson, C. A. and White, R. V.: Primary transitional cell carcinoma of prostatic periurethral ducts. Urology, 25, 339-343, 1985. – reference: 16) Araki, H., Mishina, T., Miyakoda, K., Fujiware, T. and Kobayashi, T.: An epidemiological survey of prostatic cancer from the annual of the pathological autopsy cases in Japan. Tohoku J. Exp. Med., 130, 159-164, 1980. – reference: 20) Schujman, E., Mukamel, E., Siutzaker, D., Mor, C. and Seruadio, C.: Prostatic trantional cell carcinoma: Concept of its pathogenesis and classification. Israel., J. Med. Sciences., 19, 794-800, 1983. – reference: 3) Alexander, S. J., Lee, S. S. and Bekhrad, A.: Transitional cell carcinoma of the prostate: Response to treatment with cis-platinum and cyclophnosphamide. J. Urol., 131, 975-977, 1984. – reference: 4) Karpas, C. M. and Moumgins, B.: Primary transitional cell carcinoma of prostate gland: possible pathogenesis and relationship to reserve cell hyperplasia of prostatic periuretheral ducts. J. Urol., 101, 201-205, 1969. – reference: 23) Kakizoe, T., Fujita, J., Murase, T., Matsumoto, K. and Kishi, K.: Transitional cell carcinoma of the bladder in patients with renal pelvic and ureteral cancer. J. Urol., 124, 17-19, 1980. – reference: 9) Ullmann, A. S. and Ross, O. A.: Hyperplasia, atypism and carcinoma in situ in prostatic periurethral glands. Amer. J. Clin. Path., 47, 497-505, 1967. – reference: 12) Greene, L. F., O'dea, M. J. and Dockerty, M. B.: Primary transitional cell carcinoma of the prostate. J. Urol., 116, 761-763, 1976. – reference: 21) Howe, G. R., Bunch, J. D., Miller, A. B., Cook, G. M., Esteve, J., Morrison, B., Gordon, P., Chambers, L. W., Fodor, G. and Winsor, G. M.: Tobacco use, occurpation, coffee, various nutrients, and bladder cancer. J. Natl. Cancer Inst., 64, 701-703, 1980. – reference: 27) Carmichael, J., Cornbleet, M. A., MacDougall, R. H., Allan, S. G., Duncan, W., Chisholm, G. D. and Smyth, J. F.: Cis-platin and methotrexate in the treatment of transitional cell carcinoma of the urinary tract. Brit. J. Urol., 57, 299-302, 1985. – reference: 6) Chibber, P. J., Mcintyre, M. A., Hindmarsh, J. R., Hargreave, T. B., Newsam, J. E. and Chisholm, G. D.: Transitional cell carcinoma involving the prostate. Brit. J. Urol., 53, 605-609, 1981. – reference: 8) Catalona, W. J.: Prostate cancer. Groune & Stratton, Inc. Orlando, 1984. – reference: 26) 堀内誠三, 保坂義雄, 親松常男, 中沢速和, 小松秀樹, 藤目真, 吉野伸二: 前立腺潜在性癌の治療とその成績. 日泌尿会誌, 76, 1006-1014, 1985. – reference: 5) Schellhammer, P. F., Bean, M. A. and Whitmore, W. F. Jr.: Prostatic involvement by transitional cell carcinioma: Pathogenesis, patterns and prognosis. J. Urol., 118, 399-403, 1977. – reference: 11) Catalona, W. J. and Scott, W. W.: Carcinoma of the prostate: A review. J. Urol., 119, 1-8, 1978. – reference: 1) Wolfe, J. H. N. and Lloyd-Davies, R. W.: The management of transitional cell carcinoma in the prostate. Brit. J. Urol., 53, 253-257, 1981. |
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| Snippet | 前立腺移行上皮癌は, 膀胱移行上皮癌の前立腺浸潤と病理学的にも鑑別が難しいことが時にある. 頻度的には膀胱癌の前立腺浸潤によるものの方が原発性前立腺移行上皮... 前立腺移行上皮癌は,膀胱移行上皮癌の前立腺浸潤と病理学的にも鑑別が難しいことが時にある.頻度的には膀胱癌の前立腺浸潤によるものの方が原発性前立腺移行上皮癌よりも... |
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| Subtitle | II) 膀胱移行上皮癌の前立腺浸潤例との対比 |
| Title | 前立腺移行上皮癌症例および膀胱移行上皮癌の前立腺浸潤例の検討 |
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