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Histologische Diagnostik an der Prostatastanzbiopsie

Trends in prostate biopsy interpretation

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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.

Abstract

Driven by the pressure of increasing use of PSA screening, cancer diagnosis based on histopathology has been constantly improved. When appropriate quality standards for obtaining a biopsy specimen and for tissue preparation are upheld, even the smallest tumour foci can be identified with certainty. Efforts to standardize the Gleason grading should also help to render assessments of tumour biology more precise. In addition, subtle diagnosis of precancerous or cancer-associated lesions will permit more exact prognoses of existing cancer risk to be made. There are still weak points: reliable recognition of clinically insignificant carcinomas and the danger of overtreatment. Further research activity on this topic is needed.

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  1. Institut für Pathologie, Schwerpunkt Uropathologie, Universitätsklinikum Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    J. Köllermann & G. Sauter

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  1. J. Köllermann
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  2. G. Sauter
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Correspondence to J. Köllermann.

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Köllermann, J., Sauter, G. Histologische Diagnostik an der Prostatastanzbiopsie. Urologe 48, 305–314 (2009). https://doi.org/10.1007/s00120-009-1966-8

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