Ooi Kevin, Samali Ramin
Tamworth Base Hospital, Urology, Tamworth, New South Wales, Australia.
ANZ J Surg. 2007 May;77(5):336-8. doi: 10.1111/j.1445-2197.2007.04054.x.
The aim of this study was to review the discrepancies in Gleason scores (GS) of prostate biopsies and radical prostatectomy specimens and the effects of multiple-needle biopsies on scoring accuracy.
One hundred patients who had undergone consecutive radical prostatectomies (RP) between January 2004 and May 2006 were reviewed retrospectively. Patient information including age, prebiopsy prostate-specific antigen levels, biopsy GS, RP GS and pathology details were recorded and compared.
The concordance rate of biopsy GS and RP GS was found to be at 43%, with 46% of biopsy specimens being undergraded. Eleven per cent of the specimens were overgraded. The accuracy was fairly similar when specimens were reported by the same or different pathologists, at 42 and 44%, respectively. The accuracy of biopsy GS improved with increasing number of biopsies taken.
There are significant discrepancies in Gleason scoring of biopsy and RP specimens, with a concordance rate of 43% and undergrading rate of 46%. Increasing the number of biopsies helps improve scoring accuracy. Clinicians and patients need to be mindful when deciding cancer treatment options, in view of these discrepancies.
本研究旨在回顾前列腺活检与根治性前列腺切除术标本的Gleason评分（GS）差异，以及多针活检对评分准确性的影响。
回顾性分析2004年1月至2006年5月期间连续接受根治性前列腺切除术（RP）的100例患者。记录并比较患者信息，包括年龄、活检前前列腺特异性抗原水平、活检GS、RP GS及病理细节。
活检GS与RP GS的一致率为43%，46%的活检标本分级过低。11%的标本分级过高。由同一位病理学家或不同病理学家报告标本时，准确性相当相似，分别为42%和44%。活检GS的准确性随着活检针数的增加而提高。
活检和RP标本的Gleason评分存在显著差异，一致率为43%，分级过低率为46%。增加活检针数有助于提高评分准确性。鉴于这些差异，临床医生和患者在决定癌症治疗方案时需谨慎。
