Pathologie des Prostatakarzinoms

Zusammenfassung

Hintergrund: Unter den Krebsdiagnosen entwickelter Länder steht das Prostatakarzinom an zweiter Stelle, unter den Todesursachen bei Männern an dritter Stelle.

Dieser Beitrag fasst die Pathologie des Prostatakarzinoms zusammen bezüglich neuer Methoden der Detektion und Risikostratifizierung.

Ergebnisse: Die Diagnostik, Prognoseerstellung und Therapie des Prostatakarzinoms erfordern eine enge Kooperation zwischen Urologen, Radiologen, Nuklearmedizinern, Pathologen und Strahlentherapeuten. Besonders vor dem Hintergrund neuer radiologischer und nuklearmedizinischer Verfahren der Detektion als auch neuer Methoden der Strahlentherapie ist eine solide Kenntnis des Gleason-Gradings und der TNM-Tumorklassifikation in den genannten Disziplinen Voraussetzung.

Schlussfolgerungen: Neue Methoden in der Röntgenologie und der Nuklearmedizin tragen dazu bei, sowohl lokalisierte als auch fortgeschrittene und metastasierte Prostatakarzinome besser zu erfassen. Durch diese Methoden wird auch eine gezielte Strahlentherapie ermöglicht. Die Spezifizität der neuen Methoden kann die histopathologische Diagnostik bisher nicht ersetzten, aber durch bessere Bildgebungssignale die gezielte bioptische Erfassung von Läsionen wesentlich erleichtern.

Abstract

Background: Prostate cancer is the second most frequently diagnosed cancer in developed countries and the third most common cause of death in men.

This article reviews the pathology of prostate cancer with respect to new methods of detection and risk stratification.

Results: The diagnosis, progostication and therapy of prostate cancer require a close cooperation between urology, radiology, nuclear medicine, pathology and radiotherapy. Especially on the background of new imaging methods a solid knowledge of the Gleason grading and the TNM classification systems is required.

Conclusions: New imaging methods have contributed to a better detection of localised as well as advanced, i. e. metastasized prostate cancer. These methods have also helped to reduce radiotherapy to localized cancer spots within the prostate. Although these methods cannot replace the gold standard of histopathology so far, they are extremely helpful to guide biopsy sampling.

Schlüsselwörter

Prostatakarzinom - Histopathologie - Gleasongrading - TNM

Key words

prostate cancer - histopathology - Gleason grading - TNM

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