国际泌尿病理协会2014 Gleason分级分组系统下前列腺癌根治术后病理升级的因素分析

卞浩; 欧阳骏

doi:10.13201/j.issn.1001-1420.2019.10.009

国际泌尿病理协会2014 Gleason分级分组系统下前列腺癌根治术后病理升级的因素分析

卞浩¹,
欧阳骏^2, ,

- 1. 泰州市人民医院泌尿外科(江苏泰州, 225300);
- 2. 苏州大学附属第一医院泌尿外科

详细信息

通讯作者: 欧阳骏,E-mail:18896504297@163.com

中图分类号: R737.25

收稿日期: 2018-04-12

Predictive factors for Gleason score upgrading after radical prostatectomy in 2014 ISUP Gleason Grade Groups

BIAN Hao¹,
OUYANG Jun^2, ,

- 1. Department of Urology, Taizhou People's Hospital, Jiangsu, 225300, China;
- 2. Department of Urology, First Affiliated Hospital of Soochow University

More Information

Corresponding author: OUYANG Jun, E-mail: 18896504297@163.com

Received Date: 12 April 2018

摘要

摘要: 目的：国际泌尿病理协会（ISUP）2014共识会议在2005 Gleason评分的基础上提出了一套以预后区别为基础的分组系统，称为Gleason分级分组系统（GGGs），本研究旨在研究在GGGs下前列腺癌根治术后病理较穿刺病理变化情况及根治术后发生病理升级的因素。方法：回顾性分析2014年1月~2017年6月于苏州大学附属第一医院行前列腺癌根治术的259例患者的病例资料。通过GGGs将病理结果分为五组[GG1=GS≤6、GG2=GS7（3+4）、GG3=GS7（4+3）、GG4=GS8、GG5=GS9、10]，通过单因素及Logistic回归分析研究导致根治患者Gleason分组（Gleason Groups，GGs）较穿刺GGs升级的因素。结果：259例接受根治手术的患者中，病理一致的有148例（57.14%），升级79例（30.50%），降级32例（12.36%），对于全部病例，穿刺时的GGs、临床分期>T₂期是根治术后病理升级的独立危险因素，对于穿刺GG1的病例，前列腺特异性抗原（PSA）和中性粒细胞与淋巴细胞比值（NLR）是术后病理升级的独立危险因素。结论：GGGs下前列腺癌根治术后病理升级可能性仍较高，穿刺GGs较低和临床分期>T₂期患者发生病理升级可能更大，PSA和NLR对于穿刺GG1患者病理升级具有重要的预测价值。
- 前列腺癌 /
- 前列腺癌根治术 /
- Gleason分级分组系统 /
- 病理升级
Abstract: Objective: A new prostate cancer prognostic grading system(GGGs) has been proposed based on the contemporary Gleason scores by ISUP in 2014. The objective of this study was to evaluate the concordance between the GGs of prostate biopsy and radical prostatectomy(RP) specimens and to identify predictive factors for upgrading GGs. Method: This retrospective study included total of 259 patients undergoing RP at First Affiliated Hospital of Soochow University after prostate biopsies between January 2014 and June 2017 and the upgrading was evaluated by GGGs, which have five prognostic categories:GG1 is GS ≤ 6, GG2 is GS3+4=7, GG3 is GS4+3=7, GG4 is GS8, and GG5 is GS9 and 10. Univariate logistic regression analyses and multivariate logistic regression analyses were applied to assess the potential factors. Result: The GGs of prostate biopsies and RP specimens were concordant in 57.14% of cases, while 30.5% were upgraded and 12.36% were downgraded in 259 patients. GGs at prostate biopsy and clinical T stage were significant predictors of GG upgrading in overall patients. PSA and NLR were significant predictors of GG upgrading in patients with GG1 at prostate biopsy.Conclusion: There are still a large part of patients with Gleason upgrading. Patients with lower GGs at prostate biopsy will have higher possibility to upgrade after RP. PSA and NLR were significant predictors of GG upgrading in patients with GG1 at prostate biopsy.
- prostate cancer /
- radical prostatectomy /
- Gleason Grade Groups /
- pathological upgrading

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